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Technical details and findings during a second Lichtenstein repair or a second laparoscopic repair in the same groin: a study based on medical records

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@article{21e3438edcea4a55a0098b4ccb57b414,
title = "Technical details and findings during a second Lichtenstein repair or a second laparoscopic repair in the same groin: a study based on medical records",
abstract = "PURPOSE: There are cases where surgeons repair a recurrent inguinal hernia using a second Lichtenstein repair (Lichtenstein-Lichtenstein) or a second laparoscopic repair (Laparoscopy-Laparoscopy) in the same groin even though this contradicts current guideline recommendations. The aim of this study was to provide an overview of surgical modifications and findings during these reoperations.METHODS: Patients in this observational study were identified in the nationwide Danish Hernia Database during a 6-year period. Outcomes were identified in medical records. The primary outcome was the prevalence of tailored reoperations and standard reoperations for Lichtenstein-Lichtenstein and Laparoscopy-Laparoscopy, respectively. The secondary outcomes were findings during the reoperation such as inguinal hernia type and size, fibrosis, and difficulty to identify anatomical landmarks.RESULTS: Of the 102 Lichtenstein reoperations, 43 (42%) were tailored repairs and 59 (58%) were standard repairs. The most common modifications were posterior wall reinforcement with permanent sutures, dividing a structure to enable sufficient hernioplasty, and a modification of the new mesh size and/or shape. There were no differences in the findings during tailored- and standard Lichtenstein reoperations. Of the 58 laparoscopic reoperations, 35 (60%) were tailored repairs and 23 (40%) were standard repairs. The most common modifications were necessitation of a coated mesh due to insufficient peritoneal coverage and use of unusual mesh sizes and/or shapes. Fibrosis was more commonly described during the tailored laparoscopic reoperations.CONCLUSIONS: A substantial part of the Lichtenstein- and the laparoscopic reoperations was tailored approaches, and various modifications were used. Fibrosis was more commonly described during tailored laparoscopic reoperations.",
keywords = "Findings, Lichtenstein reoperation, Modifications, Tailored repair, TAPP reoperation",
author = "Stina {\"O}berg and Jessen, {Majken Lyhne} and Kristoffer Andresen and Jacob Rosenberg",
year = "2021",
month = feb,
doi = "10.1007/s10029-019-02090-9",
language = "English",
volume = "25",
pages = "149--157",
journal = "Hernia",
issn = "1265-4906",
publisher = "Springer France",
number = "1",

}

RIS

TY - JOUR

T1 - Technical details and findings during a second Lichtenstein repair or a second laparoscopic repair in the same groin

T2 - a study based on medical records

AU - Öberg, Stina

AU - Jessen, Majken Lyhne

AU - Andresen, Kristoffer

AU - Rosenberg, Jacob

PY - 2021/2

Y1 - 2021/2

N2 - PURPOSE: There are cases where surgeons repair a recurrent inguinal hernia using a second Lichtenstein repair (Lichtenstein-Lichtenstein) or a second laparoscopic repair (Laparoscopy-Laparoscopy) in the same groin even though this contradicts current guideline recommendations. The aim of this study was to provide an overview of surgical modifications and findings during these reoperations.METHODS: Patients in this observational study were identified in the nationwide Danish Hernia Database during a 6-year period. Outcomes were identified in medical records. The primary outcome was the prevalence of tailored reoperations and standard reoperations for Lichtenstein-Lichtenstein and Laparoscopy-Laparoscopy, respectively. The secondary outcomes were findings during the reoperation such as inguinal hernia type and size, fibrosis, and difficulty to identify anatomical landmarks.RESULTS: Of the 102 Lichtenstein reoperations, 43 (42%) were tailored repairs and 59 (58%) were standard repairs. The most common modifications were posterior wall reinforcement with permanent sutures, dividing a structure to enable sufficient hernioplasty, and a modification of the new mesh size and/or shape. There were no differences in the findings during tailored- and standard Lichtenstein reoperations. Of the 58 laparoscopic reoperations, 35 (60%) were tailored repairs and 23 (40%) were standard repairs. The most common modifications were necessitation of a coated mesh due to insufficient peritoneal coverage and use of unusual mesh sizes and/or shapes. Fibrosis was more commonly described during the tailored laparoscopic reoperations.CONCLUSIONS: A substantial part of the Lichtenstein- and the laparoscopic reoperations was tailored approaches, and various modifications were used. Fibrosis was more commonly described during tailored laparoscopic reoperations.

AB - PURPOSE: There are cases where surgeons repair a recurrent inguinal hernia using a second Lichtenstein repair (Lichtenstein-Lichtenstein) or a second laparoscopic repair (Laparoscopy-Laparoscopy) in the same groin even though this contradicts current guideline recommendations. The aim of this study was to provide an overview of surgical modifications and findings during these reoperations.METHODS: Patients in this observational study were identified in the nationwide Danish Hernia Database during a 6-year period. Outcomes were identified in medical records. The primary outcome was the prevalence of tailored reoperations and standard reoperations for Lichtenstein-Lichtenstein and Laparoscopy-Laparoscopy, respectively. The secondary outcomes were findings during the reoperation such as inguinal hernia type and size, fibrosis, and difficulty to identify anatomical landmarks.RESULTS: Of the 102 Lichtenstein reoperations, 43 (42%) were tailored repairs and 59 (58%) were standard repairs. The most common modifications were posterior wall reinforcement with permanent sutures, dividing a structure to enable sufficient hernioplasty, and a modification of the new mesh size and/or shape. There were no differences in the findings during tailored- and standard Lichtenstein reoperations. Of the 58 laparoscopic reoperations, 35 (60%) were tailored repairs and 23 (40%) were standard repairs. The most common modifications were necessitation of a coated mesh due to insufficient peritoneal coverage and use of unusual mesh sizes and/or shapes. Fibrosis was more commonly described during the tailored laparoscopic reoperations.CONCLUSIONS: A substantial part of the Lichtenstein- and the laparoscopic reoperations was tailored approaches, and various modifications were used. Fibrosis was more commonly described during tailored laparoscopic reoperations.

KW - Findings

KW - Lichtenstein reoperation

KW - Modifications

KW - Tailored repair

KW - TAPP reoperation

UR - http://www.scopus.com/inward/record.url?scp=85075643080&partnerID=8YFLogxK

U2 - 10.1007/s10029-019-02090-9

DO - 10.1007/s10029-019-02090-9

M3 - Journal article

C2 - 31786701

VL - 25

SP - 149

EP - 157

JO - Hernia

JF - Hernia

SN - 1265-4906

IS - 1

ER -

ID: 62071257