Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks

Background Irritation of inguinal nerves with laparoscopic hernia repair may cause chronic neuralgia and hypoesthesia. Hypoesthesia in particular is generally not assessed objectively. We objectively investigated hypoesthesia and chronic pain after transabdominal preperitoneal inguinal hernia repair...

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Veröffentlicht in:Surgical endoscopy 2012-04, Vol.26 (4), p.1079-1085
Hauptverfasser: Brügger, Lukas, Bloesch, Martina, Ipaktchi, Ramin, Kurmann, Anita, Candinas, Daniel, Beldi, Guido
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container_end_page 1085
container_issue 4
container_start_page 1079
container_title Surgical endoscopy
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creator Brügger, Lukas
Bloesch, Martina
Ipaktchi, Ramin
Kurmann, Anita
Candinas, Daniel
Beldi, Guido
description Background Irritation of inguinal nerves with laparoscopic hernia repair may cause chronic neuralgia and hypoesthesia. Hypoesthesia in particular is generally not assessed objectively. We objectively investigated hypoesthesia and chronic pain after transabdominal preperitoneal inguinal hernia repair (TAPP) with titanium spiral tacks (STs) compared with tissue adhesive (TA) for mesh fixation. Methods Mesh fixation in 80 TAPP procedures was randomized to fixation with ST ( n  = 40) or TA ( n  = 40). The outcome parameters included hypoesthesia assessed with von Frey monofilaments, early postoperative and chronic pain with the visual analog scale (VAS), morbidity (surgical-site infection, hematoma/seroma, relapse of hernia, trocar hernia), and recovery time to normal activity. Results Median (range) follow-up was 38 (13–56) months. Demographic and baseline parameters were similar in the two groups. Prevalence of hypoesthesia was significantly higher at all postoperative times in the ST group (6 weeks: 32 vs. 6%; 6 months: 38 vs. 14%; 12 months: 34 vs. 13%; 13–56 months: 32 vs. 4%). Mean hypoesthesia scores over all time points were significantly higher in the ST group. The percentages of regions with hypoesthesia (abdominal, inguinal, or genitofemoral) following all procedures were higher in the ST group after 6 weeks (14 vs. 2%), 6 months (15 vs. 5%), and 13–56 months (22 vs. 4%). The intensity of pain decreased significantly in both groups over time. Conclusions Postoperative hypoesthesia depends on the method of mesh fixation during TAPP and is significantly reduced with TA compared with stapling.
doi_str_mv 10.1007/s00464-011-2003-8
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Hypoesthesia in particular is generally not assessed objectively. We objectively investigated hypoesthesia and chronic pain after transabdominal preperitoneal inguinal hernia repair (TAPP) with titanium spiral tacks (STs) compared with tissue adhesive (TA) for mesh fixation. Methods Mesh fixation in 80 TAPP procedures was randomized to fixation with ST ( n  = 40) or TA ( n  = 40). The outcome parameters included hypoesthesia assessed with von Frey monofilaments, early postoperative and chronic pain with the visual analog scale (VAS), morbidity (surgical-site infection, hematoma/seroma, relapse of hernia, trocar hernia), and recovery time to normal activity. Results Median (range) follow-up was 38 (13–56) months. Demographic and baseline parameters were similar in the two groups. Prevalence of hypoesthesia was significantly higher at all postoperative times in the ST group (6 weeks: 32 vs. 6%; 6 months: 38 vs. 14%; 12 months: 34 vs. 13%; 13–56 months: 32 vs. 4%). Mean hypoesthesia scores over all time points were significantly higher in the ST group. The percentages of regions with hypoesthesia (abdominal, inguinal, or genitofemoral) following all procedures were higher in the ST group after 6 weeks (14 vs. 2%), 6 months (15 vs. 5%), and 13–56 months (22 vs. 4%). The intensity of pain decreased significantly in both groups over time. Conclusions Postoperative hypoesthesia depends on the method of mesh fixation during TAPP and is significantly reduced with TA compared with stapling.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-011-2003-8</identifier><identifier>PMID: 22044970</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adhesives ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Chronic pain ; Chronic Pain - etiology ; Cyanoacrylates - adverse effects ; Digestive system. 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Hypoesthesia in particular is generally not assessed objectively. We objectively investigated hypoesthesia and chronic pain after transabdominal preperitoneal inguinal hernia repair (TAPP) with titanium spiral tacks (STs) compared with tissue adhesive (TA) for mesh fixation. Methods Mesh fixation in 80 TAPP procedures was randomized to fixation with ST ( n  = 40) or TA ( n  = 40). The outcome parameters included hypoesthesia assessed with von Frey monofilaments, early postoperative and chronic pain with the visual analog scale (VAS), morbidity (surgical-site infection, hematoma/seroma, relapse of hernia, trocar hernia), and recovery time to normal activity. Results Median (range) follow-up was 38 (13–56) months. Demographic and baseline parameters were similar in the two groups. Prevalence of hypoesthesia was significantly higher at all postoperative times in the ST group (6 weeks: 32 vs. 6%; 6 months: 38 vs. 14%; 12 months: 34 vs. 13%; 13–56 months: 32 vs. 4%). Mean hypoesthesia scores over all time points were significantly higher in the ST group. The percentages of regions with hypoesthesia (abdominal, inguinal, or genitofemoral) following all procedures were higher in the ST group after 6 weeks (14 vs. 2%), 6 months (15 vs. 5%), and 13–56 months (22 vs. 4%). The intensity of pain decreased significantly in both groups over time. Conclusions Postoperative hypoesthesia depends on the method of mesh fixation during TAPP and is significantly reduced with TA compared with stapling.</description><subject>Abdominal Surgery</subject><subject>Adhesives</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Chronic pain</subject><subject>Chronic Pain - etiology</subject><subject>Cyanoacrylates - adverse effects</subject><subject>Digestive system. 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Abdomen</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernia, Inguinal - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Herniorrhaphy - methods</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypesthesia - etiology</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy</topic><topic>Length of Stay</topic><topic>Ligaments</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Pain, Postoperative - etiology</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Surgery</topic><topic>Surgical Mesh</topic><topic>Surgical outcomes</topic><topic>Surgical Stapling - adverse effects</topic><topic>Surgical techniques</topic><topic>Tissue Adhesives - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brügger, Lukas</creatorcontrib><creatorcontrib>Bloesch, Martina</creatorcontrib><creatorcontrib>Ipaktchi, Ramin</creatorcontrib><creatorcontrib>Kurmann, Anita</creatorcontrib><creatorcontrib>Candinas, Daniel</creatorcontrib><creatorcontrib>Beldi, Guido</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health &amp; Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health &amp; Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brügger, Lukas</au><au>Bloesch, Martina</au><au>Ipaktchi, Ramin</au><au>Kurmann, Anita</au><au>Candinas, Daniel</au><au>Beldi, Guido</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>26</volume><issue>4</issue><spage>1079</spage><epage>1085</epage><pages>1079-1085</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background Irritation of inguinal nerves with laparoscopic hernia repair may cause chronic neuralgia and hypoesthesia. Hypoesthesia in particular is generally not assessed objectively. We objectively investigated hypoesthesia and chronic pain after transabdominal preperitoneal inguinal hernia repair (TAPP) with titanium spiral tacks (STs) compared with tissue adhesive (TA) for mesh fixation. Methods Mesh fixation in 80 TAPP procedures was randomized to fixation with ST ( n  = 40) or TA ( n  = 40). The outcome parameters included hypoesthesia assessed with von Frey monofilaments, early postoperative and chronic pain with the visual analog scale (VAS), morbidity (surgical-site infection, hematoma/seroma, relapse of hernia, trocar hernia), and recovery time to normal activity. Results Median (range) follow-up was 38 (13–56) months. Demographic and baseline parameters were similar in the two groups. Prevalence of hypoesthesia was significantly higher at all postoperative times in the ST group (6 weeks: 32 vs. 6%; 6 months: 38 vs. 14%; 12 months: 34 vs. 13%; 13–56 months: 32 vs. 4%). Mean hypoesthesia scores over all time points were significantly higher in the ST group. The percentages of regions with hypoesthesia (abdominal, inguinal, or genitofemoral) following all procedures were higher in the ST group after 6 weeks (14 vs. 2%), 6 months (15 vs. 5%), and 13–56 months (22 vs. 4%). The intensity of pain decreased significantly in both groups over time. Conclusions Postoperative hypoesthesia depends on the method of mesh fixation during TAPP and is significantly reduced with TA compared with stapling.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22044970</pmid><doi>10.1007/s00464-011-2003-8</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Abdominal Surgery
Adhesives
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Chronic pain
Chronic Pain - etiology
Cyanoacrylates - adverse effects
Digestive system. Abdomen
Endoscopy
Female
Gastroenterology
General aspects
Gynecology
Hepatology
Hernia, Inguinal - surgery
Hernias
Herniorrhaphy - adverse effects
Herniorrhaphy - methods
Hospitals
Humans
Hypesthesia - etiology
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy
Length of Stay
Ligaments
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Pain, Postoperative - etiology
Proctology
Prospective Studies
Recurrence
Surgery
Surgical Mesh
Surgical outcomes
Surgical Stapling - adverse effects
Surgical techniques
Tissue Adhesives - adverse effects
title Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks
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