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Japanese

Prospective comparative study of transabdominal preperitoneal repair (TAPP) using self-gripping mesh(ProGripTM)versus mesh fixation with staples for primary unilateral adult inguinal hernia Takayuki SUTO 1 , Hisataka FUJIWARA 1 , Fumitaka ENDO 1 , Akira UMEMURA 1 , Seika NAKAMURA 1 , Akira SASAKI 2 1Department of Surgery, Morioka Municipal Hospital 2Department of Surgery, Iwate Medical University Keyword: パリテックスTM ラップ プログリップTM メッシュ , transabdominal preperitoneal repair 法 , TAPP法 , 鼠径ヘルニア pp.495-503
Published Date 2018/7/15
DOI https://doi.org/10.11477/mf.4426200579
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The fixation of the mesh with staples is usually performed in transabdomoinal preperitoneal repair(TAPP) procedure. In recent years, the self-gripping mesh (ProGripTM) which does not need staples has attracted attention because of its less postoperative pain and complications. The aim of this prospective study is to evaluate the safety and feasibility of TAPP using self-gripping mesh (SG-TAPP) versus mesh fixation with staples (ST-TAPP) for adult patients with primary unilateral inguinal hernia. One hundred patients were randomly assigned to either SG-TAPP or ST-TAPP group from October 2015 through April 2017. We evaluated the operative outcomes. Postoperative scores of wound pain, affected inguinal pain and the patient's wound satisfaction were assessed by visual analogue scale (VAS). As a result, all TAPP procedures were successfully accomplished without addition of a trocar or converting to open approach. There was no statistical difference between the groups in the following categories; operation time, bleeding volume, length of hospital stay, VAS scores of wound pain and inguinal pain on postoperative day 1 and 14, VAS score of patient's satisfaction on postoperative day 14, use of analgesics and postoperative complications. There was no major complication detected and neither approach encountered recurrences. The fixation with staples had little effect on acute postoperative inguinal pain. In conclusion, SG-TAPP procedure is equally safe and feasible technique when compared with ST-TAPP ; SG-TAPP, however, was cost effective. Therefore SG-TAPP could potentially become a gold standard for adult inguinal hernia repair.


Copyright © 2018, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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