Efficacy Comparison of 3D Max Lightweight Patch and Standard Patch in Laparoscopic Transabdominal Preperitoneal Herniorrhaphy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MACheng-zhi ,  SUNYan

Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China;

Corresponding?author：

SUNYan, Email: 13936099121@163.com

Keywords：

Inguinal hernia; Transabdominal preperitoneal herniorrhaphy; Lightweight patch; Postoperative pain; Postoperative foreign body sensation

DOI：

10.7507/1007-9424.20150350

Video：

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Objective To compare the safety, effectiveness, and stability of 3D Max lightweight patch and standard patch in laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy. Methods The clinical data of 147 patients who underwent laparoscopic TAPP herniorrhaphy with 3D Max from May 2013 to May 2014 in this hospital were collected. Of all the patients, the lightweight patches were used in 75 patients (observation group), the standard patches were used in 72 patients (control group). The mean operative time, mean early postoperative ambulation time, mean bleeding volume, postoperative pain, postoperative foreign body sensation, complications, average hospital stay, and average costs were compared between these two groups. The postoperative pain point was determined by using visual analogue scale (VAS). The foreign body sensation of postoperative groin area was determined basing on the pain point. Results There were no significant differences in the terms of the mean operation time, the mean early postoperative ambulation time, the mean bleeding volume, the average costs, and the average hospital stay between the observation group and the control group (P > 0.05). On postoperative 2 d, the pain point of the observation group was slightly lower than that of the control group, but there was no statistically significant difference between these two groups (P=0.132); On postoperative 1 month and 6 months, the postoperative pain points of the observation group were significantly lower than those of the control group, the differences were statistically significant (P=0.031, P=0.018). There was no recurrence of hernia and complications in the two groups. Conclusions The cost of 3D Max lightweight patch in laparoscopic TAPP herniorrhaphy application is slightly higher than that in standard patch, but it could alleviate postoperative pain, reduce postoperative foreign body sensation, and make patients feel more comfortable. It is safe, effective, and stable in clinical application of laparoscopic TAPP herniorrhaphy.

Citation： MACheng-zhi, SUNYan. Efficacy Comparison of 3D Max Lightweight Patch and Standard Patch in Laparoscopic Transabdominal Preperitoneal Herniorrhaphy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(11): 1347-1350. doi: 10.7507/1007-9424.20150350 Copy

1.	?Bringman S, Ramel S, Heikkinen TJ, et al. Tension-free inguinal hernia repair:TEP versus mesh-plug versus Lichtenstein:a prospective randomized controlled trial. Ann Surg, 2003, 237(1):142-147.
2.	Eklund A, Rudberg C, Smedberg S, et al. Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg, 2006, 93(9):1060-1068.
3.	趙健, 郭天康.腹腔鏡與開放式無張力疝修補術治療成人復發性腹股溝疝療效Meta分析.中國實用外科雜志, 2015, 35(1):86-93.
4.	Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair:a meta-analysis of randomized controlled trials. Surg Endosc, 2005, 19(2):188-199.
5.	蔡濤, 劉芳, 何艷.腹腔鏡疝修補與普通平片疝修補臨床比較分析.中國普通外科雜志, 2014, 23(12):1727-1729.
6.	Soltés M, Pazinka P, Radonak J. Laparoscopic hernioplasty TAPP in treatment of groin hernia-10 years experience. Rozhl Chir, 2010, 89(6):384-389.
7.	林林, 周保軍, 張占學, 等.輕量型網片腹膜前疝修補手術與疝環充填式修補手術的對比研究.中華疝和腹壁外科雜志:電子版, 2012, 6(1):532-536.
8.	吳繼營, 李水薇, 謝翠芳, 等.改良腹腔鏡經腹腹膜前腹股溝疝修補術.腹腔鏡外科雜志, 2011, 16(12):940-942.
9.	Wei FX, Yc Z, Han W, et al. Transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) for laparoscopic hernia repair:a Meta-Analysis. Surg Laparosc Endosc Percutan Tech, 2015 Feb 26.[Epub ahead of print].
10.	K?ckerling F, Schug-Pass C. What do we know about titanized polypropylene meshes? An evidence-based review of the literature. Hernia, 2014, 18(4):445-457.
11.	高峰, 李榮江, 張晶銳, 等.腹腔鏡完全腹膜外腹股溝疝修補術中3D補片免固定技術的臨床應用體會.中國普外基礎與臨床雜志, 2015, 22(3):346-347.
12.	祿韶英, 佘軍軍, 祁光裕, 等.腹腔鏡下應用3DMax補片行腹股溝疝修補術(附18例報道).中國普外基礎與臨床雜志, 2010, 17(9):974-975.
13.	Bittner R, Schmedt CG, Leibl BJ, et al. Early postoperative and one year results of a randomized controlled trial comparing the impact of extralight titanized polypropylene mesh and traditional heavyweight polypropylene mesh on pain and seroma production in laparoscopic hernia repair (TAPP). Word J Surg, 2011, 35(8):1791-1797.
14.	朱紹輝, 王建國.巴德3D Max補片完全腹膜外腹腔鏡疝修補術.
15.	例報告.中華疝和腹壁外科雜志:電子版, 2009, 3(3):271-274.
16.	中華醫學會外科學會疝和腹壁外科學組.成人腹股溝疝股疝手術治療方案(修訂稿).腹部外科, 2004, 17(1):63.
17.	付鴻江.自固定輕量補片在腹腔鏡下腹股溝疝修補中的應用.中華疝和腹壁外科雜志:電子版, 2014, 8(1):60-62.
18.	Ayiomamitis GD, Zaravinos A, Stathakis PC, et al. Tacks-free transabdominal preperitoneal (TAPP) inguinal hernioplasty, using an anatomic 3-dimensional lightweight mesh with peritoneal suturing:pain and recurrence outcomes-initial experience. Surg Laparosc Endosc Percutan Tech, 2013, 23(4):e150-e155.
19.	黃磊, 唐健雄, 蔡昭, 等.輕量型網塞在腹股溝疝修補術中的應用.外科理論與實踐, 2008, 13(6):535-537.
20.	張志峰.腹股溝疝無張力修補術與傳統疝修補術的臨床療效對比觀察.當代醫學, 2013, 19(28):116.
21.	Agarwal BB, Agarwal KA, Mahajan KC. Prospective double-blind randomized controlled study comparing heavy-and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia:early results. Surg Endosc, 2009, 23(2):242-247.
22.	袁喜紅, 周凱, 華麗, 等.輕質量型補片在老年腹股溝疝無張力疝修補術中的臨床應用.中國老年學雜志, 2014, 17(17):4758-4759, 4760.
23.	Champault G, Barrat C. Inguinal hernia repair with beta glucan-coated mesh:results at two-year follow up. Hernia, 2005, 9(2):125-130.
24.	Klosterhalfen B, Junge K, Klinge U. The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices, 2005, 2(1):103-117.
25.	Smietański M, Bury K, Smietańska IA, et al. Five-year results of a randomised controlled multi-centre study comparing heavy-weight knitted versus low-weight, non-woven polypropylene implants in Lichtenstein hernioplasty. Hernia, 2011, 15(5):495-501.
26.	Peitsch WK. A modified laparoscopic hernioplasty (TAPP) is the standard procedure for inguinal and femoral hernias:a retrospective 17-year analysis with 1123 hernia repairs. Surg Endosc, 2014, 28(2):671-682.
27.	Bansal VK, Misra MC, Babu D, et al. A prospective, randomized comparison of long-term outcomes:chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surg Endosc, 2013, 27(7):2373-2382.
28.	單保安, 洪亮, 計小剛, 等.不釘合補片的腹腔鏡下全腹膜外免氣囊分離器腹股溝疝修補術分析(附32例報道).中國普外基礎與臨床雜志, 2009, 16(2):102-104.
29.	程韜, 李俊生.重量型補片與輕量型補片應用于腹股溝疝修補術的Meta分析.中華疝和腹壁外科雜志:電子版, 2011, 5(2):136-143.
30.	陳新民.腹腔鏡疝修補術與開放式無張力疝修補術治療腹股溝疝的療效對比.中國醫藥指南, 2013, 14(14):588-589.

1. ?Bringman S, Ramel S, Heikkinen TJ, et al. Tension-free inguinal hernia repair:TEP versus mesh-plug versus Lichtenstein:a prospective randomized controlled trial. Ann Surg, 2003, 237(1):142-147.
2. Eklund A, Rudberg C, Smedberg S, et al. Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg, 2006, 93(9):1060-1068.
3. 趙健, 郭天康.腹腔鏡與開放式無張力疝修補術治療成人復發性腹股溝疝療效Meta分析.中國實用外科雜志, 2015, 35(1):86-93.
4. Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair:a meta-analysis of randomized controlled trials. Surg Endosc, 2005, 19(2):188-199.
5. 蔡濤, 劉芳, 何艷.腹腔鏡疝修補與普通平片疝修補臨床比較分析.中國普通外科雜志, 2014, 23(12):1727-1729.
6. Soltés M, Pazinka P, Radonak J. Laparoscopic hernioplasty TAPP in treatment of groin hernia-10 years experience. Rozhl Chir, 2010, 89(6):384-389.
7. 林林, 周保軍, 張占學, 等.輕量型網片腹膜前疝修補手術與疝環充填式修補手術的對比研究.中華疝和腹壁外科雜志:電子版, 2012, 6(1):532-536.
8. 吳繼營, 李水薇, 謝翠芳, 等.改良腹腔鏡經腹腹膜前腹股溝疝修補術.腹腔鏡外科雜志, 2011, 16(12):940-942.
9. Wei FX, Yc Z, Han W, et al. Transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) for laparoscopic hernia repair:a Meta-Analysis. Surg Laparosc Endosc Percutan Tech, 2015 Feb 26.[Epub ahead of print].
10. K?ckerling F, Schug-Pass C. What do we know about titanized polypropylene meshes? An evidence-based review of the literature. Hernia, 2014, 18(4):445-457.
11. 高峰, 李榮江, 張晶銳, 等.腹腔鏡完全腹膜外腹股溝疝修補術中3D補片免固定技術的臨床應用體會.中國普外基礎與臨床雜志, 2015, 22(3):346-347.
12. 祿韶英, 佘軍軍, 祁光裕, 等.腹腔鏡下應用3DMax補片行腹股溝疝修補術(附18例報道).中國普外基礎與臨床雜志, 2010, 17(9):974-975.
13. Bittner R, Schmedt CG, Leibl BJ, et al. Early postoperative and one year results of a randomized controlled trial comparing the impact of extralight titanized polypropylene mesh and traditional heavyweight polypropylene mesh on pain and seroma production in laparoscopic hernia repair (TAPP). Word J Surg, 2011, 35(8):1791-1797.
14. 朱紹輝, 王建國.巴德3D Max補片完全腹膜外腹腔鏡疝修補術.
15. 例報告.中華疝和腹壁外科雜志:電子版, 2009, 3(3):271-274.
16. 中華醫學會外科學會疝和腹壁外科學組.成人腹股溝疝股疝手術治療方案(修訂稿).腹部外科, 2004, 17(1):63.
17. 付鴻江.自固定輕量補片在腹腔鏡下腹股溝疝修補中的應用.中華疝和腹壁外科雜志:電子版, 2014, 8(1):60-62.
18. Ayiomamitis GD, Zaravinos A, Stathakis PC, et al. Tacks-free transabdominal preperitoneal (TAPP) inguinal hernioplasty, using an anatomic 3-dimensional lightweight mesh with peritoneal suturing:pain and recurrence outcomes-initial experience. Surg Laparosc Endosc Percutan Tech, 2013, 23(4):e150-e155.
19. 黃磊, 唐健雄, 蔡昭, 等.輕量型網塞在腹股溝疝修補術中的應用.外科理論與實踐, 2008, 13(6):535-537.
20. 張志峰.腹股溝疝無張力修補術與傳統疝修補術的臨床療效對比觀察.當代醫學, 2013, 19(28):116.
21. Agarwal BB, Agarwal KA, Mahajan KC. Prospective double-blind randomized controlled study comparing heavy-and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia:early results. Surg Endosc, 2009, 23(2):242-247.
22. 袁喜紅, 周凱, 華麗, 等.輕質量型補片在老年腹股溝疝無張力疝修補術中的臨床應用.中國老年學雜志, 2014, 17(17):4758-4759, 4760.
23. Champault G, Barrat C. Inguinal hernia repair with beta glucan-coated mesh:results at two-year follow up. Hernia, 2005, 9(2):125-130.
24. Klosterhalfen B, Junge K, Klinge U. The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices, 2005, 2(1):103-117.
25. Smietański M, Bury K, Smietańska IA, et al. Five-year results of a randomised controlled multi-centre study comparing heavy-weight knitted versus low-weight, non-woven polypropylene implants in Lichtenstein hernioplasty. Hernia, 2011, 15(5):495-501.
26. Peitsch WK. A modified laparoscopic hernioplasty (TAPP) is the standard procedure for inguinal and femoral hernias:a retrospective 17-year analysis with 1123 hernia repairs. Surg Endosc, 2014, 28(2):671-682.
27. Bansal VK, Misra MC, Babu D, et al. A prospective, randomized comparison of long-term outcomes:chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surg Endosc, 2013, 27(7):2373-2382.
28. 單保安, 洪亮, 計小剛, 等.不釘合補片的腹腔鏡下全腹膜外免氣囊分離器腹股溝疝修補術分析(附32例報道).中國普外基礎與臨床雜志, 2009, 16(2):102-104.
29. 程韜, 李俊生.重量型補片與輕量型補片應用于腹股溝疝修補術的Meta分析.中華疝和腹壁外科雜志:電子版, 2011, 5(2):136-143.
30. 陳新民.腹腔鏡疝修補術與開放式無張力疝修補術治療腹股溝疝的療效對比.中國醫藥指南, 2013, 14(14):588-589.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Efficacy Comparison of 3D Max Lightweight Patch and Standard Patch in Laparoscopic Transabdominal Preperitoneal Herniorrhaphy

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