A Meyer1, L Bonnet2, M Bourbon2, P Blanc2. 1. Abdominal Wall Repair Center, General Surgeon, Samaritano Hospital, São Paulo, Brazil. Electronic address: alberto.meyer@usp.br. 2. Clinique Mutualiste Chirurgicale, Saint-Étienne, France.
Abstract
BACKGROUND: Totally extraperitoneal (TEP) endoscopic inguinal hernia repair is indicated for recurrent and bilateral inguinal hernias and traditionally is performed under general anesthesia. However, interventions that minimize pain and reduce opioid consumption have certain advantages for patients by avoiding side effects such as nausea and vomiting. The transversus abdominis plane (TAP) block has been used to minimize pain in a diverse range of surgical procedures but its safety on patients undergoing TEP repair has yet to be investigated. AIM: To assess the results of outpatient TEP repair with TAP block without curare. METHODS: Consecutive patients undergoing elective TEP procedure were prospectively enrolled. Patients in two institutes received a similar anesthetic, surgical, and analgesic treatment protocol. RESULTS: Fifty consecutive day-case patients were included in this series. The TEP repair was successful in 49 patients and there was one conversion to transabdominal pre-peritoneal (TAPP) endoscopic inguinal hernia repair. The mean duration of surgery was 20min for unilateral hernia and 40min for bilateral hernia. CONCLUSION: These preliminary results suggest that day-case endoscopic hernia repair (TEP) with TAP block without curare is effective, safe, reproducible and can be proposed in all patients.
BACKGROUND: Totally extraperitoneal (TEP) endoscopic inguinal hernia repair is indicated for recurrent and bilateral inguinal hernias and traditionally is performed under general anesthesia. However, interventions that minimize pain and reduce opioid consumption have certain advantages for patients by avoiding side effects such as nausea and vomiting. The transversus abdominis plane (TAP) block has been used to minimize pain in a diverse range of surgical procedures but its safety on patients undergoing TEP repair has yet to be investigated. AIM: To assess the results of outpatientTEP repair with TAP block without curare. METHODS: Consecutive patients undergoing elective TEP procedure were prospectively enrolled. Patients in two institutes received a similar anesthetic, surgical, and analgesic treatment protocol. RESULTS: Fifty consecutive day-case patients were included in this series. The TEP repair was successful in 49 patients and there was one conversion to transabdominal pre-peritoneal (TAPP) endoscopic inguinal hernia repair. The mean duration of surgery was 20min for unilateral hernia and 40min for bilateral hernia. CONCLUSION: These preliminary results suggest that day-case endoscopic hernia repair (TEP) with TAP block without curare is effective, safe, reproducible and can be proposed in all patients.
Authors: C Paasch; J Fiebelkorn; G De Santo; N Aljedani; P Ortiz; U Gauger; K Boettge; S H Full; S Anders; M Hünerbein Journal: Ann Med Surg (Lond) Date: 2020-09-22
Authors: C Paasch; N Aljedani; P Ortiz; S Azarhoush; J Fiebelkorn; K A Boettge; U Gauger; S Anders; G De Santo; M W Strik Journal: Ann Med Surg (Lond) Date: 2020-06-08
Authors: Christoph Paasch; Jennifer Fiebelkorn; Gianluca De Santo; Sascha Azarhoush; Katherina Boettge; Stefan Anders; Ulrich Gauger; Martin Strik Journal: Ann Med Surg (Lond) Date: 2020-05-23
Authors: Woojin Kwon; Seunguk Bang; Hyojung Soh; Won Jun Jeong; Sang Chul Lee; Byung Jo Choi Journal: Medicine (Baltimore) Date: 2018-06 Impact factor: 1.889