To Ligate or Not to Ligate? Managing the Difficult Indirect Sac in Laparoscopic Totally Extraperitoneal Repair of the Inguinal Hernia

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Chandra Kishor JakhmolaShivraj Singh Chauhan

Abstract

A laparoscopic approach to repair of inguinal hernia has become popular. The reduction of an indirect sac can be challenging especially if it is long standing or is large. In such situations, the established practice is to divide the sac at the neck and ligate it. Ligation of the sac has been shown to cause increased postoperative pain. Hence we postulated that we could possibly avoid ligation of this divided sac without causing increased intraoperative difficulty or postoperative complications. This was a retrospective review of a prospectively maintained database of all patients who underwent laparoscopic totally extraperitoneal repair (TEP) during a 7-year period at our center with a minimum of 1 year of follow-up. We compared the outcomes of the patients who underwent only a division (group I) versus those who underwent division followed by ligation (group II) of the indirect sac. There were 189 and 126 patients in groups I and II, respectively. Group I patients fared better in terms of operative times and postoperative pain scores. The postoperative complication and short-term outcomes were not significantly different between the two groups. Non-ligation of a divided indirect sac during TEP is feasible and has the advantag...Continue Reading

References

Oct 1, 1977·The British Journal of Surgery·H Ellis, R Heddle
Apr 1, 1984·The Surgical Clinics of North America·S G SmedbergA Gullmo
Feb 3, 1999·The Surgical Clinics of North America·J Abrahamson
Feb 20, 2003·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Hung Lau, Francis Lee
Apr 14, 2004·Archives of Surgery·Timothy J BabineauMichael Stone
Apr 1, 2009·Journal of Indian Association of Pediatric Surgeons·Veena KumariSukanta K Das
Apr 30, 2013·Journal of Minimal Access Surgery·Ameet Kumar, T S Ramakrishnan
May 28, 2015·International Journal of Surgery·Chun-Yu KaoKa-Wai Tam
Dec 15, 2015·Medical Journal, Armed Forces India·C K Jakhmola, Ameet Kumar

❮ Previous
Next ❯

Citations

Apr 27, 2021·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Junsheng LiTao Cheng

❮ Previous
Next ❯

Methods Mentioned

BETA
dissection

Software Mentioned

GraphPad

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.