The results of laparoscopic without fixing аllohernioplasty in the treatment of inguinal hernias
Abstract
Background. The relevance of this study is confirmed by the unsolved number of issues
related to the results of treatment of inguinal hernias. Despite the best
experience in the treatment of inguinal hernias, there are postoperative
complications such as pain and relapses. With the development of laparoscopic
treatment, the percentage of the above-mentioned complications
has significantly decreased. But there are still questions: whether it is
necessary to fix the mesh endoprosthesis, what material should preferably be
the mesh endoprosthesis, the optimal size of the mesh endoprosthesis.
The aim is to improve the
results of surgical treatment for patients with inguinal hernias by using a
rational method of placement and fixation of the polyproplastic endoprosthesis
during laparoscopic hernioplasty.
Material and methods. The work was performed based on the results of surgical treatment of
patients with inguinal hernias from 2015 to 2020. Patients entered the study
based on inclusion, non-inclusion, and exclusion criteria. In total, the study
included 207 patients. The patients were randomly divided into the main
and control groups. The main group included 102 patients. All patients in
this group underwent laparoscopic hernioplasty of inguinal hernias without
fixing the mesh polypropylene endoprosthesis with a herniastepler. The
control group included 105 patients who underwent laparoscopic
hernioplasty of inguinal hernias with a mesh endoprosthesis with fixation
of the latter using a Protack 5.0 herniostepler with titanium spiral clips. To
assess the immediate results of treatment in the comparison groups we assessed
the following criteria: duration of surgery, the severity of postoperative
pain by Visual Analogue Scale (VAS), frequency and severity of post-operative
complications, estimated on a scale of Clavien-Dindo, the dose of the
analgesics (opioid derivates), the average length of hospitalization and
the presence or absence of early recurrence of inguinal hernia estimated by the
moose thumb assessment of the superficial inguinal ring, "cough
push" symptom and ultrasound examination of the inguinal region.
Results. The duration of surgery, postoperative complications, the average length of
hospitalization, and the postoperative period for relapses did not differ
significantly in both study groups. The level of postoperative pain, estimated
by VAS and the dose of the prescribed narcotic analgesic, is significantly
lower in the main group.
Conclusion. The developed technique of performing laparoscopic inguinal hernioplasty
without fixing the endoprosthesis with a hernioplayer can improve the quality
of life of patients in the immediate postoperative period: the pain
syndrome is significantly lower, there are no relapses.
Keywords:inguinal hernia, laparoscopic hernia repair, hernias stapler
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Zaitsev O.V., Koshkina A.V., Yudin V.A., Barsukov V.V., Bragina I.Yu. The
results of laparoscopic without fixing allohernioplasty in the treatment of
inguinal hernias. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9
(3): 59-66. DOI: https://doi.org/10.33029/2308-1198-2021-9-3-59-66 (in Russian)
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