Transinguinal Periperitoneal Technique in Inguinal Hernioplasty

NCT ID: NCT06270472

Last Updated: 2024-02-21

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 20 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-03-01
• Study Completion Date: 2025-04-01

Brief Summary

evaluation of feasibility and efficacy of trans inguinal periperitoneal technique by using conventional mesh inguinal hernia repair in general surgery department in Assiut university hospitals

Detailed Description

Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide with approximately 20 million cases every year . The open Lichtenstein tension-free hernioplasty is most commonly performed and recognized for its low recurrence rate and short learning curve, but associated with an undesirably high level of postoperative chronic groin pain, up to 10-35% . Therefore, chronic groin pain is a common concern after inguinal hernia surgery. Treatment of chronic groin pain can be challenging and may require several interventions including, local anaesthesia , corticosteroids or additional surgery . Several studies showed that chronic groin pain might be dependent on the surgical technique, including identification and handling of inguinal nerves ,Preperitoneal techniques like the transinguinal preperitoneal patch (TIPP )have been developed to minimize these risks. The TIPP technique which introduced by prissier involves a standard anterior inguinal approach, with high dissection and preperitoneal reduction use of a PolySoft mesh have been proved to cause less chronic pain than the Lichtenstein technique. The PolySoft mesh is a lightweight polypropylene mesh, tailored in asymmetric oval shape that contains a recoil ring. Recent studies deficient in evaluation feasibility and efficacy of trans inguinal periperitoneal technique by using conventional mesh in inguinal hernia repair . So the aim of our study to evaluate the use of conventional mesh in transinguinal preperitoneal technique in inguinal hernioplasty .

Conditions

Hernia, Inguinal

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Interventions

hernioplasty

The polysome repair was carried out as described by pelisse . In the case of a lateral hernia, the spermatic cord was mobilised and the cremasteric fibers were separated (in men). The hernia sac was dissected from the cord structures and reduced in the preperitoneal space through the internal ring. A dissection gauze was inserted through the internal ring to create the preperitoneal space. The medial border of the internal ring and the epigastric vessels were lifted with a refractor and blunt digital dissection was carried out in the preperitoneal space in all directions. A pocket was created to allow a complete expansion of the mesh. The conventional mesh was introduced with blunt forceps and, after the gauze has been removed, positioned in the preperitoneal space .

In the case of a medial hernia, the preperitoneal space was reached by incising the transversalis fascia around the base of the sac. Completion of the repair is the same as the lateral hernia procedure.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients more than 18 years
• fit for surgery.

Exclusion Criteria

• Patients less than 18 years
• American Society of Anesthesiologists (ASA) 3 : a patient with severe systemic disease as ( poorly treated hypertension or diabetes , morbid obesity , chronic renal failure , stable angina & implanted pacemaker ) .

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Ahmed Elsayed Mohamed Elsayed

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

ahmed elsayed

Role: CONTACT

elsayedahmed994@gmail.com

01021892279

morsy mohamed

Role: CONTACT

morssy@aun.edu.eg

01093688097

References

Messias BA, Almeida PL, Ichinose TMS, Mocchetti ER, Barbosa CA, Waisberg J, Roll S, Ribeiro Junior MF. The Lichtenstein technique is being used adequately in inguinal hernia repair: national analysis and review of the surgical technique. Rev Col Bras Cir. 2023 Dec 8;50:e20233655. doi: 10.1590/0100-6991e-20233655-en. eCollection 2023.

Reference Type: BACKGROUND

PMID: 38088634 (View on PubMed)

Damous SHB, Damous LL, Borges VA, Fontella AK, Miranda JDS, Koike MK, Saito OC, Birolini CAV, Utiyama EM. Bilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) technique. Surg Endosc. 2023 Dec;37(12):9263-9274. doi: 10.1007/s00464-023-10499-8. Epub 2023 Oct 25.

Reference Type: BACKGROUND

PMID: 37880447 (View on PubMed)

Shekouhi R, Farz F, Sohooli M, Mohammadi S, Abbasi A, Razaghi M, Fereydouni M, Sohrabi M, Seyed-Alagheband SA, Darabi MH. Investigating the safety and efficacy of nerve stimulation for management of groin pain after surgical herniorrhaphy: a systematic review and meta-analysis. Hernia. 2023 Dec;27(6):1363-1373. doi: 10.1007/s10029-023-02861-5. Epub 2023 Aug 19.

Reference Type: BACKGROUND

PMID: 37597107 (View on PubMed)

Other Identifiers

tipp technique

Identifier Type: -

Identifier Source: org_study_id