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- Bringman, Sven, et al.
(författare)
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Feasibility of a combined percutaneous laparoscopic three-millimeter device
- 2014
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Ingår i: Journal of the Society of Laparoendoscopic Surgeons. - 1086-8089 .- 1938-3797. ; 18:1, s. 41-45
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: NeedlescoJ instruments induce minimal trauma and produce excellent cosmetic results. A combination of a 3-mm abdominal wall incision and a 5-mm instrument in the abdominal cavity would combine the beneficial features of these two different sizes.Methods: The Percutaneous Surgical System (PSS) (Ethicon EndoSurgety, Galway, Ireland) is a new instrument consisting of a 3-mm shaft that is introduced percutaneously into the abdominal cavity. Through a 5-mm trocar, a. loader with a 5-mm attachment such as a Maryland dissector is introduced. The attachment is connected to the shaft, and the loader is removed from the abdomen. The feasibility of this device was evaluated retrospectively in 3 Swedish hospitals between January and September 2012.Results: Twenty-eight patients were laparoscopically operated on (cholecystectomy, gastric bypass, fundoplication, incisional hernias, and totally extraperitoneal repair for inguinal hernia) by use of 1 or 2 PSSs in each operation (47 in total). It was feasible to use the PSS in all procedures except during the totally extraperitoneal repair procedure because of the limited available preperitoneal space. Especially in laparoscopic cholecystectomies, the two lateral 5-mm trocars were easily replaced by two 3-mm PSS instruments.Conclusions: The use of the PSS is feasible in a number of laparoscopic procedures, where it can replace 5-mm trocars. Randomized controlled trials are needed to determine the future role of the PSS versus, for example, needlescopic laparoscopy.
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| 2. |
- Ruiz-Jasbon, Fernando, et al.
(författare)
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TEP With Long-Term Resorbable Mesh in Patients With Indirect Inguinal Hernia.
- 2018
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Ingår i: JSLS : Journal of the Society of Laparoendoscopic Surgeons. - 1938-3797. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- The role of long-term degradable implants in reducing the risk of chronic postoperative pain after inguinal hernia repair is still unclear. A pilot study using a synthetic long-term resorbable mesh in Lichtenstein repair showed good results regarding pain and discomfort in patients with indirect inguinal hernia (IH) without recurrences, but higher recurrence rate in patients with direct inguinal hernia (DH). The purpose of this study was to assess the incidence of pain and early recurrence in patients with LIH surgically treated with the TEP technique using a long-term degradable mesh. This is the first human study to use long-term degradable mesh with the TEP approach.This study was prospective, including 35 primary IHs surgically treated with TEP repair using TIGR Mesh (Novus Scientific Pte, Ltd, Singapore). At the 1-year follow-up recurrence was assessed by clinical examination and the incidence of pain or discomfort was assessed before and after surgery by Visual Analog Scale (VAS) and Inguinal Pain Questionnaire (IPQ).After 12 months, no patients had chronic pain. Only 1 (2.8%) patient reported pain using the VAS (score = 2), and 4 patients reported pain that could easily be ignored. All 4 patients reported less pain 1 year after the operation using both IPQ and VAS, compared with the preoperative assessment. One patient (2.8%) developed a recurrence 20 months after the primary operation.TEP repair using a synthetic long-term resorbable mesh was found to be safe and promising regarding pain and discomfort at 1-year follow-up in patients with IH. Longer follow-up is necessary to establish the risk of recurrence.
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