Mohamed Mahmood Nasr1. 1. University Medical Center, Arabian Gulf University, Manama, Kingdom of Bahrain. drmdnasr@gmail.com.
Abstract
BACKGROUND: In this study, the proposed technique is combining the invented method of extraperitoneal dissection utilizing gas insufflation through Veress needle introduced from the groin with the transabdominal approach. Such a combination minimizes operative demands, achieves major goals, and reduce operative time in an attempt to improve laparoscopic hernioplasty techniques. METHODS: The study recruited 211 patients having primary reducible inguinal hernia upon first diagnosis. Abdominal ultrasound examination achieved to exclude any additional pathology and confirming clinical diagnosis. The new technique is applied on all patients without any modification through the whole series. RESULTS: Patients' epidemiology, operative characteristics, and follow-up are all tabulated. Results showed no complications nor conversion to open procedure. CONCLUSIONS: The proposed procedure showed preliminary encouraging results regarding technique, clinical outcome, time-saving, and patients' safety. Combination of extraperitoneal gas-derived dissection, transabdominal field review, and preperitoneal mesh application offers an innovative and promising laparoscopic hernioplasty technique. The study is introducing the technique and as well invites further trials on wider scale to verify the technique.
BACKGROUND: In this study, the proposed technique is combining the invented method of extraperitoneal dissection utilizing gas insufflation through Veress needle introduced from the groin with the transabdominal approach. Such a combination minimizes operative demands, achieves major goals, and reduce operative time in an attempt to improve laparoscopic hernioplasty techniques. METHODS: The study recruited 211 patients having primary reducible inguinal hernia upon first diagnosis. Abdominal ultrasound examination achieved to exclude any additional pathology and confirming clinical diagnosis. The new technique is applied on all patients without any modification through the whole series. RESULTS:Patients' epidemiology, operative characteristics, and follow-up are all tabulated. Results showed no complications nor conversion to open procedure. CONCLUSIONS: The proposed procedure showed preliminary encouraging results regarding technique, clinical outcome, time-saving, and patients' safety. Combination of extraperitoneal gas-derived dissection, transabdominal field review, and preperitoneal mesh application offers an innovative and promising laparoscopic hernioplasty technique. The study is introducing the technique and as well invites further trials on wider scale to verify the technique.
Entities:
Keywords:
Gas tissue dissection; Preperitoneal gas dissection transabdominal hernioplasty; Totally extraperitoneal hernioplasty; Transabdominal preperitoneal hernioplasty
Authors: R Bittner; M A Montgomery; E Arregui; V Bansal; J Bingener; T Bisgaard; H Buhck; M Dudai; G S Ferzli; R J Fitzgibbons; R H Fortelny; K L Grimes; U Klinge; F Köckerling; F Koeckerling; S Kumar; J Kukleta; D Lomanto; M C Misra; S Morales-Conde; W Reinpold; J Rosenberg; K Singh; M Timoney; D Weyhe; P Chowbey Journal: Surg Endosc Date: 2014-11-15 Impact factor: 4.584
Authors: Gustavo L Carvalho; Marcelo P Loureiro; Eduardo A Bonin; Christiano P Claus; Frederico W Silva; Antonio M Cury; Flavio A M Fernandes Journal: JSLS Date: 2012 Oct-Dec Impact factor: 2.172