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.	赵健, 郭天康.腹腔镜与开放式无张力疝修补术治疗成人复发性腹股沟疝疗效Meta分析.中国实用外科杂志, 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.	蔡涛, 刘芳, 何艳.腹腔镜疝修补与普通平片疝修补临床比较分析.中国普通外科杂志, 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, 周保军, 张占学, 等.轻量型网片腹膜前疝修补手术与疝环充填式修补手术的对比研究.中华疝和腹壁外科杂志:电子版, 2012, 6(1):532-536.
8.	吴继营, 李水薇, 谢翠芳, 等.改良腹腔镜经腹腹膜前腹股沟疝修补术.腹腔镜外科杂志, 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.	Köckerling 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, 李荣江, 张晶锐, 等.腹腔镜完全腹膜外腹股沟疝修补术中3D补片免固定技术的临床应用体会.中国普外基础与临床杂志, 2015, 22(3):346-347.
12.	禄韶英, 佘军军, 祁光裕, 等.腹腔镜下应用3DMax补片行腹股沟疝修补术(附18例报道).中国普外基础与临床杂志, 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.	朱绍辉, 王建国.巴德3D Max补片完全腹膜外腹腔镜疝修补术.
15.	例报告.中华疝和腹壁外科杂志:电子版, 2009, 3(3):271-274.
16.	中华医学会外科学会疝和腹壁外科学组.成人腹股沟疝股疝手术治疗方案(修订稿).腹部外科, 2004, 17(1):63.
17.	付鸿江.自固定轻量补片在腹腔镜下腹股沟疝修补中的应用.中华疝和腹壁外科杂志:电子版, 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.	黄磊, 唐健雄, 蔡昭, 等.轻量型网塞在腹股沟疝修补术中的应用.外科理论与实践, 2008, 13(6):535-537.
20.	张志峰.腹股沟疝无张力修补术与传统疝修补术的临床疗效对比观察.当代医学, 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.	袁喜红, 周凯, 华丽, 等.轻质量型补片在老年腹股沟疝无张力疝修补术中的临床应用.中国老年学杂志, 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.	单保安, 洪亮, 计小刚, 等.不钉合补片的腹腔镜下全腹膜外免气囊分离器腹股沟疝修补术分析(附32例报道).中国普外基础与临床杂志, 2009, 16(2):102-104.
29.	程韬, 李俊生.重量型补片与轻量型补片应用于腹股沟疝修补术的Meta分析.中华疝和腹壁外科杂志:电子版, 2011, 5(2):136-143.
30.	陈新民.腹腔镜疝修补术与开放式无张力疝修补术治疗腹股沟疝的疗效对比.中国医药指南, 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. 赵健, 郭天康.腹腔镜与开放式无张力疝修补术治疗成人复发性腹股沟疝疗效Meta分析.中国实用外科杂志, 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. 蔡涛, 刘芳, 何艳.腹腔镜疝修补与普通平片疝修补临床比较分析.中国普通外科杂志, 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, 周保军, 张占学, 等.轻量型网片腹膜前疝修补手术与疝环充填式修补手术的对比研究.中华疝和腹壁外科杂志:电子版, 2012, 6(1):532-536.
8. 吴继营, 李水薇, 谢翠芳, 等.改良腹腔镜经腹腹膜前腹股沟疝修补术.腹腔镜外科杂志, 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. Köckerling 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, 李荣江, 张晶锐, 等.腹腔镜完全腹膜外腹股沟疝修补术中3D补片免固定技术的临床应用体会.中国普外基础与临床杂志, 2015, 22(3):346-347.
12. 禄韶英, 佘军军, 祁光裕, 等.腹腔镜下应用3DMax补片行腹股沟疝修补术(附18例报道).中国普外基础与临床杂志, 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. 朱绍辉, 王建国.巴德3D Max补片完全腹膜外腹腔镜疝修补术.
15. 例报告.中华疝和腹壁外科杂志:电子版, 2009, 3(3):271-274.
16. 中华医学会外科学会疝和腹壁外科学组.成人腹股沟疝股疝手术治疗方案(修订稿).腹部外科, 2004, 17(1):63.
17. 付鸿江.自固定轻量补片在腹腔镜下腹股沟疝修补中的应用.中华疝和腹壁外科杂志:电子版, 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. 黄磊, 唐健雄, 蔡昭, 等.轻量型网塞在腹股沟疝修补术中的应用.外科理论与实践, 2008, 13(6):535-537.
20. 张志峰.腹股沟疝无张力修补术与传统疝修补术的临床疗效对比观察.当代医学, 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. 袁喜红, 周凯, 华丽, 等.轻质量型补片在老年腹股沟疝无张力疝修补术中的临床应用.中国老年学杂志, 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. 单保安, 洪亮, 计小刚, 等.不钉合补片的腹腔镜下全腹膜外免气囊分离器腹股沟疝修补术分析(附32例报道).中国普外基础与临床杂志, 2009, 16(2):102-104.
29. 程韬, 李俊生.重量型补片与轻量型补片应用于腹股沟疝修补术的Meta分析.中华疝和腹壁外科杂志:电子版, 2011, 5(2):136-143.
30. 陈新民.腹腔镜疝修补术与开放式无张力疝修补术治疗腹股沟疝的疗效对比.中国医药指南, 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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