Assessment of mesh displacement following laparoscopic enhanced view totally extraperitoneal technique: comparing mesh fixation and non-fixation in difficult inguinal hernias.

IF 2.4 3区医学 Q2 SURGERY

Updates in Surgery Pub Date : 2025-05-28 DOI:10.1007/s13304-025-02271-5

Abdullah Hilmi Yilmaz, Mehmet Esref Ulutas

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引用次数: 0

Abstract

Background: Mesh fixation, one of the controversial issues of laparoscopic surgery, has not been investigated in the enhanced view-totally extraperitoneal (eTEP) technique. This study aimed to compare mesh fixation (FX) and non-fixation (NFX) in difficult cases in the eTEP technique.

Methods: A total of 61 consecutive patients diagnosed with inguinal hernias who underwent the eTEP procedure were randomized for the study. The groups were FX and NFX. The primary outcome was mesh displacement; secondary outcomes were recurrence, return to normal life, pain, and postoperative findings.

Results: Mesh displacement, recurrence, mean operative time, length of stay, pneumoperitoneum, and postoperative complications were similar. VAS scores were higher in the FX group (p = 0.017, p < 0.001, p < 0.001, respectively). Return to normal life was more days in the FX group (p = 0.02). The mesh displacement at 6 months was higher than at 1 month in both groups (p < 0.001).

Conclusions: There is no increased risk of mesh displacement and recurrence in difficult cases, such as scrotal and recurrent hernias, without mesh fixation. With the eTEP technique, mesh fixation can be safely avoided for less pain and a faster return to normal life.

Trial registration: Clinicaltrials number: NCT06417359.

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腹腔镜增强视野全腹膜外技术后补片移位的评估：比较补片固定与不固定在难治性腹股沟疝中的作用。

背景：补片固定是腹腔镜手术中有争议的问题之一，在全腹膜外增强视点（eTEP）技术中尚未进行研究。本研究旨在比较网状固定（FX）和非固定（NFX）在eTEP技术困难病例中的应用。方法：共有61例连续诊断为腹股沟疝并接受eTEP手术的患者被随机纳入研究。两组分别为FX和NFX。主要结果是网片位移；次要结局是复发、恢复正常生活、疼痛和术后表现。结果：补片移位、复发、平均手术时间、住院时间、气腹和术后并发症相似。FX组的VAS评分较高（p = 0.017, p）。结论：在阴囊疝、复发疝等疑难病例中，不使用补片固定不会增加补片移位和复发的风险。使用eTEP技术，可以安全地避免网状固定，减少疼痛，更快地恢复正常生活。试验注册：临床试验号：NCT06417359。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Updates in Surgery Medicine-Surgery

CiteScore

4.50

自引率

7.70%

发文量

208

期刊介绍： Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.