Abstract | PURPOSE: The aim of this study was to compare the transinguinal preperitoneal technique ( TIPP) using a memory ring patch versus the Lichtenstein technique in relation to acute and chronic pain, post-operative complications and recurrence rates. METHODS: During an 18-month period, all adult patients that needed treatment for a unilateral inguinal or femoral hernia were treated by the TIPP repair using the Polysoft mesh. This group was retrospectively compared with a historical cohort of patients treated by the Lichtenstein technique. Our policy concerning type of anaesthesia, post-operative pain management and visual analogue scale measurements did not change over the study period. For post-operative pain evaluation, the visual analogue scale was used (0-10) and scores were measured after 6 h, 24 h, 1 week, 1 month, 1 year and yearly thereafter. Recurrence rates were evaluated at time of clinical examinations. RESULTS: In total, 142 patients have been analysed with the TIPP technique (group I) versus 136 patients operated in the previous 2 years with a Lichtenstein repair (group II). In group I, 112 patients (78.9%) received a medium size patch of 14 x 7.5 cm and 30 patients (21.1%) had a large patch (16 x 9 cm). The mean operative time for a TIPP procedure was statistically shorter than for a Lichtenstein repair, 33 versus 44 min, respectively (p = 0.04). After 24 h, 1 week and 1 month post-surgery, there was significantly less post-operative pain observed in the TIPP group than in the Lichtenstein group. In total, four recurrences were observed in the TIPP group (2.8%), of which one laterally and three medially. In group II, seven recurrences were observed in total (5.1%), of which five were detected within 2 years of follow-up (3.7%). CONCLUSION: For surgeons performing the Lichtenstein repair but looking for modifications concerning pain relief and a quicker procedure, the TIPP approach is a feasible alternative that seems to be associated with less post-operative pain.
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Authors | Frederik Berrevoet, Leander Maes, Koen Reyntjens, Xavier Rogiers, Roberto Troisi, Bernard de Hemptinne |
Journal | Langenbeck's archives of surgery
(Langenbecks Arch Surg)
Vol. 395
Issue 5
Pg. 557-62
(Jun 2010)
ISSN: 1435-2451 [Electronic] Germany |
PMID | 19644704
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Analysis of Variance
- Chi-Square Distribution
- Female
- Hernia, Inguinal
(surgery)
- Humans
- Male
- Middle Aged
- Minimally Invasive Surgical Procedures
- Pain Measurement
- Pain, Postoperative
(prevention & control)
- Postoperative Complications
(prevention & control)
- Recurrence
- Retrospective Studies
- Surgical Mesh
- Treatment Outcome
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