Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair under Spinal Anesthesia vs General Anesthesia: A Prospective Study
Keywords:
Inguinal hernia, laparoscopic total extraperitoneal hernia repair, spinal anesthesiaAbstract
Objective: To compare the safety, cost and effectiveness of laparoscopic total extraperitoneal hernia repair(TEP) under spinal anesthesia (SA) with those of TEP under general anesthesia (GA).
Materials and methods: Between June 2012 and June 2013, 60 patients undergoing laparoscopic TEP under
spinal and general anesthesia at Priest Hospital were prospectively followed. The demographic data, intraoperative
events, pain score, analgesic use, anesthesia cost and complications were recorded.
Results: There were 30 patients in each group. Unilateral/bilateral hernias in SA and GA groups were 26/4
and 23/7 respectively. No patient in the SA group was converted to GA. Ten patients (33%) in the SA group
complained of shoulder or chest discomfort and required sedation. There were no significant differences in pain
scores at 4 and 24 hours, meperidine doses or postoperative complications between the two groups. Cost to the
patients was less in the SA group.
Conclusion: Laparoscopic TEP under SA was as safe and effective as that performed under GA but was less
expensive. Laparoscopic TEP under SA could be an alternative for patients who have contraindications to GA.
References
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SurgLaparosEndoscPercutan Tech 2003;13:185-90.
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Laparoscopic total extraperitoneal (TEP) inguinal hernia
repair under epidural anesthesia: a detailed evaluation.
Surg Endosc 2007;21:595-601.
8. Sinha R, Gurwara AK, Gupta SC. Laparoscopic total
extraperitoneal inguinal hernia repair under spinal
anesthesia: a study of 480 patients. J Laparoendosc AdvSurg
Tech 2008;18:673-7.
9. Tzovaras G, Symeonidis D, Koukoulis G, et al. Long-term
results after laparoscopic transabdominal preperitoneal
(TAPP) inguinal herniarepair under spinal anesthesia. Hernia
2012;16:641-5.
10. Ismail M, Garg P. Laparoscopic inguinal total extraperitoneal
hernia repair under spinal anesthesia withoutmesh fixation
in 1220 hernia repairs. Hernia 2009;13:115-9.
11. Molinelli BM, Tagliavia A, Bernstein D. Total extraperitoneal
preperitoneal laparoscopic hernia repair usingspinal
anesthesia. JSLS 2006;10:341-4.
12. Spivak H, Nudelman I, Fuco V. Laparoscopic extraperitoneal
inguinal hernia repair with spinal anesthesia and nitrous
oxide insufflations. Surg Endosc 1999;13:1026-9.
13. Zacharoulis D, Fafoulakis F, Baloyiannis I, et al. Laparoscopic
transabdominal preperitoneal repair of inguinal hernia
under spinal anesthesia: a pilot study. Am J Surg 2009;198:456-
9.
14. Lau H, Wong C, Chu K, Patil NG. Endoscopic totally
extraperitoneal inguinal hernioplasty under spinal anesthesia.
J Laparoendosc Adv Surg Tech 2005;15:121-4.
15. Azurin DJ, Go LS, Cwik JC, Schuricht AL. The efficacy of
epidural anesthesia for endoscopic preperitoneal
herniorrhaphy: a prospective study. J Lap Surg 1996;6:369-
73.
16. Gerges FJ, Kanazi GE, Jabbour-khoury SI. Anesthesia for
laparoscopy: a review. J Clin Anesth 2006;18:67-78.
17. Collins LM, Vaghadia H. Regional anesthestia for
laparoscopy. Anesthesiol Clin N A 2001;19:43-55.
inguinal hernia. Surg Endosc 2010;24:974-6.
2. Puri V, Felix E, Fitzgibbons RJ Jr. Laparoscopic vs conventional
tension free inguinal herniorrhaphy: 2005 Society of American
gastrointestinal endoscopic surgeons (SAGES) annual
meeting debate. Surg Endosc 2006;20:1809-16.
3. Bittner R, Arregui ME, Bisgaard T, et al. Guidelines for
laparoscopic (TAPP) and endoscopic (TEP) treatment of
inguinal hernia [International Endohernia Society (IEHS)].
Surg Endosc 2011;25:2773-843.
4. Kuhry E, Veen RN, Langeveld HR, Steyerberg EW, Jeekel J,
Bonjer HJ. Open or endoscopic total extraperitonealinguinal
hernia repair? A systemic review.SurgEndosc 2007;21:161-
66.
5. Karthikesalingam A, Markar SR, Holt PJE, Praseedom RK.
Meta-analysis of randomized controlled trials comparing
laparoscopic with open mesh repair of recurrent inguinal
hernia. Br JSurg 2010;97:4-11.
6. Chowbey PK, Sood J, VashisthaA et al. Extraperitoneal
endoscopic groin hernia repair under epidural anesthesia.
SurgLaparosEndoscPercutan Tech 2003;13:185-90.
7. Lai P, Philips P, Saxena KN, Kajla RK, Ramteke VK.
Laparoscopic total extraperitoneal (TEP) inguinal hernia
repair under epidural anesthesia: a detailed evaluation.
Surg Endosc 2007;21:595-601.
8. Sinha R, Gurwara AK, Gupta SC. Laparoscopic total
extraperitoneal inguinal hernia repair under spinal
anesthesia: a study of 480 patients. J Laparoendosc AdvSurg
Tech 2008;18:673-7.
9. Tzovaras G, Symeonidis D, Koukoulis G, et al. Long-term
results after laparoscopic transabdominal preperitoneal
(TAPP) inguinal herniarepair under spinal anesthesia. Hernia
2012;16:641-5.
10. Ismail M, Garg P. Laparoscopic inguinal total extraperitoneal
hernia repair under spinal anesthesia withoutmesh fixation
in 1220 hernia repairs. Hernia 2009;13:115-9.
11. Molinelli BM, Tagliavia A, Bernstein D. Total extraperitoneal
preperitoneal laparoscopic hernia repair usingspinal
anesthesia. JSLS 2006;10:341-4.
12. Spivak H, Nudelman I, Fuco V. Laparoscopic extraperitoneal
inguinal hernia repair with spinal anesthesia and nitrous
oxide insufflations. Surg Endosc 1999;13:1026-9.
13. Zacharoulis D, Fafoulakis F, Baloyiannis I, et al. Laparoscopic
transabdominal preperitoneal repair of inguinal hernia
under spinal anesthesia: a pilot study. Am J Surg 2009;198:456-
9.
14. Lau H, Wong C, Chu K, Patil NG. Endoscopic totally
extraperitoneal inguinal hernioplasty under spinal anesthesia.
J Laparoendosc Adv Surg Tech 2005;15:121-4.
15. Azurin DJ, Go LS, Cwik JC, Schuricht AL. The efficacy of
epidural anesthesia for endoscopic preperitoneal
herniorrhaphy: a prospective study. J Lap Surg 1996;6:369-
73.
16. Gerges FJ, Kanazi GE, Jabbour-khoury SI. Anesthesia for
laparoscopy: a review. J Clin Anesth 2006;18:67-78.
17. Collins LM, Vaghadia H. Regional anesthestia for
laparoscopy. Anesthesiol Clin N A 2001;19:43-55.
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Published
2013-09-30
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1.
Tantiwattanasirikul P, Saenghirunvattana R. Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair under Spinal Anesthesia vs General Anesthesia: A Prospective Study. Thai J Surg [Internet]. 2013 Sep. 30 [cited 2024 May 8];34(3). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226734
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