Strangulated Inguinal Hernia
Conditions
Keywords
Inguinal hernia, Strangulated, TREPP, Transrectus sheath pre-peritoneal
Brief summary
n the Sint Jansdal Hospital in Harderwijk, the Netherlands, the TREPP technique is the standard operating procedure for patients with inguinal hernia. Starting from 2006, this procedure has also been used on patients that presented with an acute strangulated inguinal hernia in the emergency department, instead of the more common Lichtenstein technique. The goal of this retrospective case series is to assess the feasibility of the TREPP technique in case of an acute strangulated inguinal hernia. Patient records from 2006 until 2016 will be used to search for patients treated for acute inguinal hernia in that period. After applying the in- and exclusion criteria, patients who are eligible for inclusion will be contacted by telephone. They will be asked if they are willing to visit the surgical outpatient department once and fill out two questionnaires. The data of these questionnaires will be analyzed and published.
Interventions
PROCEDUREemergency transrectus sheath pre-peritoneal mesh repair (e-TREPP)
The Trans REctussheath PrePeritoneal mesh repair (TREPP) was developed in 2006 as an open preperitoneal technique to reduce CPIP. In short: a 4-5 centimeters (cm) transverse incision is made about 1 cm above the localization of the deep inguinal ring. The anterior rectus sheath is opened. After retracting the rectus muscle medially, the preperitoneal space (PPS) is bluntly dissected and a complete overview can be achieved. All possible hernia orifices can be visualized such as: a direct, indirect, pantaloon, and/or femoral hernia. A self-expandable mesh is then positioned in the PPS. Due to the upstream principle no mesh fixation is necessary.
Sponsors
St Jansdal Hospital
University Medical Center Groningen
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Emergency surgery for suspected strangulated inguinal hernia (within 6 hours after admission) * e-TREPP performed
Exclusion criteria
* No emergency surgery (for instance, surgery day after admission or later). * No e-TREPP performed
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chronic postoperative inguinal pain according to Visual Analog Scale | From surgery date up to 12 years postoperatively | Patients will be asked to fill out the VAS on a horizontal line of 10 millimeters long. Patients will be asked to mark the point that indicated the amount of pain they experience. The distance from the left marker will be measured, with increasing distance at greater pain intensity. |
| Recurrence rate | From surgery date up to 12 years postoperatively | Patient electronic records will be searched for re-operations for recurrent inguinal hernia. Also, patients will be asked in the outpatient department if they received recurrence surgery or suffer new complaints. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sexual complaints related to e-TREPP | Between >30 days postoperatively and through study completion, average 6 years | All patients will be asked if they experienced any sexual problems related to the e-TREPP surgery. |
| Short-term complications | Complications occuring from the start of the operation up to 30 days postoperative | Short term complications included: hematoma, wound infection, re-admission rate, medical complications and death. These complications will be retrospectively analyzed via the electronic patient files. They will be verified at the outpatient department. |
Countries
Netherlands
Outcome results
None listed