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Background: The utilization of laparoscopic and open inguinal hernia repair in China remains unclear. We aim to investigate the rates of laparoscopic and open inguinal hernia repairs and its associated factors at a large hernia center. Methods: Data were obtained from the front sheet of medical records of Beijing Chaoyang hospital. Adult inguinal hernia inpatients who underwent hernia repairs between 2013 and 2020 were included. We calculated the overall rates of laparoscopic and open inguinal hernia repairs and compared the rate of laparoscopic repairs between different sex, age groups, types, and sides of inguinal hernias. Multivariable logistic regression was used to examine factors associated with the rate of laparoscopic repairs. Results: 14,481 inpatients with inguinal hernia were included. 91.78% were male, 75.43% were more than 50 years, 75.20% were unilateral inguinal hernia, and 64.57% were indirect inguinal hernia. Overall, 49.47% underwent laparoscopic repairs and 50.53% underwent open repairs. Women had lower rate of laparoscopic repair than men, especially in those with unilateral hernias. Bilateral and direct inguinal hernia had higher rates of laparoscopic repair than unilateral and indirect inguinal hernia. Multivariable logistic regression showed that inpatients who were women, > 70 years, pantaloon inguinal hernia, with obstruction, and more comorbidities were less likely to have laparoscopic repairs. Conclusion: Around 50% of inguinal hernia patients at a large hernia center underwent laparoscopic repairs, which was more commonly performed in male, young, bilateral inguinal hernia, and inpatients without comorbidities. More efforts were needed to increase the safe and effective laparoscopic utilization among female patients with inguinal hernias. [ABSTRACT FROM AUTHOR]

Purpose: The myopectineal orifice (MPO) is a weak area at lower part of the anterior abdominal wall that directly determines the mesh size required in inguinal hernia repair. However, MPO data have mainly been acquired from measurements of cadavers or anesthetized patients. Furthermore, there are very few reports on the measurement of the MPO in Chinese patients. The present study aimed to use three-dimensional visualization technology to measure the MPO in live non-anesthetized Chinese patients, and to use this information to indicate the appropriate mesh size required for inguinal hernia repair. Methods: In this study, we used the parameters of the MPO and the pelvis that were measured in 40 patients with peripheral arterial disease of the lower limb arteries (80 inguinal regions) using Medraw software (Image Medraw Technology Co., Ltd., China). Results: The result showed that the average width and height of the MPO were 5.71 ± 0.99 cm and 4.96 ± 0.69 cm, respectively (5.22 ± 0.77 cm and 5.13 ± 0.63 cm in males, and 6.20 ± 0.95 cm and 4.80 ± 0.71 cm in females). The average projected area of the MPO was 16.06 ± 4.37 cm2 on the left, and 15.61 ± 4.10 cm2 on the right (P > 0.05). Conclusion: Three-dimensional visualization was used to measure the area, width, and height of the MPO in living non-anesthetized Chinese patients. MPO area was correlated with age, but not with pelvic parameters. [ABSTRACT FROM AUTHOR]

BACKGROUND: In inguinal hernia repair, the choice of mesh based on the characteristics of a single piece of mesh remains controversial. The long-term outcome of hernia recurrence and mesh-specific complications need to be evaluated. OBJECTIVE: To investigate the effects of 3D Max mesh versus common mesh for laparoscopic inguinal hernia repair on surgical outcomes and quality of life. METHODS: 142 patients with uncomplicated inguinal hernia who received treatment between February 2013 and January 2016 in Qinhuangdao Cerebrovascular Disease Hospital were included in this study. These patients consisted of 131 males and 11 females and were aged 18-60 years. They were randomly divided into a 3D Max mesh group(n=80) and ordinary mesh group(n=62) according to the mesh materials used. Surgical details and outcomes, recurrence rate, complications and hospitalization costs were recorded. Quality of life was evaluated before surgery, 2 weeks and 1, 6, 12 and 24 months after surgery using the Carolinas Comfort Scale. The study was approved by the Medical Ethics Committee of Qinhuangdao Cerebrovascular Disease Hospital, China(approval No. 2013-002-02). RESULTS AND CONCLUSION:(1) The operation time, time to ambulation, and hospitalization expense in the 3D Max mesh group were significantly reduced compared with the ordinary mesh group(P < 0.05). The incidence of seroma in the 3D Max mesh group was significantly lower than that in the ordinary mesh group(7.5%, 21.5%, P < 0.001). There were no significant differences in the incidences of hernia and other complications between 3D Max mesh and ordinary mesh groups(P > 0.05).(2) The pain sensation score in the 3D Max mesh group at 2 weeks and 1 month after surgery was significantly lower than that in the ordinary mesh group(P < 0.05). At 2 weeks and 1, 6, 12, and 24 months after surgery, there were no significant differences in total quality of life score, score of colic sensation, and motor limitation between 3D Max mesh and ordinary mesh groups(P > 0.05).(3) These results suggest that compared with ordinary mesh, 3D Max mesh can effectively shorten operation time, decrease hospitalization expense, and decrease the incidence of postoperative short-time chronic pain. [ABSTRACT FROM AUTHOR]

Introduction: Inguinal hernia is the most common disease in pediatric surgery and is induced by congenital processus vaginalis patency. Almost all inguinal hernias are inguinal indirect hernias, and herniorrhaphy has accounted for about 15% of all pediatric operations. In the past 20 years, with the development of minimally invasive technology, laparoscopic inguinal herniorrhaphy has been emerging in China and in other countries. Aim: To introduce a new technique for treating inguinal hernia in children, and evaluate the feasibility and surgical efficacy of a transumbilical single-port laparoscopic water-injection hernia crochet needle in treating pediatric inguinal hernia. Material and methods: Clinical data of 136 inguinal hernial children treated using a transumbilical single-port laparoscopic water-injection hernia crochet needle in our hospital from June 2017 to December 2018 were retrospectively analyzed. Results: All procedures were successfully accomplished, and no case was converted to a different procedure; the average operation time was 16 min for one side and 35 min for both sides. Patients were followed for an average of 10 months after surgery. One patient had a line-knot reaction at the inguinal puncture point 3 months after surgery and recovered after conservative treatment, and no recurrent case was observed after surgery. Conclusions: It is feasible to treat pediatric inguinal hernia through a transumbilical single-port laparoscopic water- injection hernia crochet needle, which is associated with safety, less trauma, rapid recovery, no obvious scar, and satisfactory efficacy. Therefore, it is worthy of being promoted and applied in clinical practice. [ABSTRACT FROM AUTHOR]