Factors Associated With Postoperative Pain in Patients Undergoing TAPP Hernia Repair for Inguinal Hernia

Overview

The most common symptom after an inguinal hernia is postoperative pain. According to the severity of the pain, the quality of life of the patient is also affected. There are many factors associated with postoperative pain. In this study, the results related to the factors affecting postoperative pain were investigated.

Full Title of Study: “Factors Associated With Postoperative Pain in Patients Undergoing Transabdominal Preperitoneal Hernia Repair for Inguinal Hernia”

Study Type

• Study Type: Observational
• Study Design
  • Time Perspective: Prospective
• Study Primary Completion Date: March 1, 2023

Detailed Description

The most common symptom after an inguinal hernia is postoperative pain. According to the severity of the pain, the quality of life of the patient is also affected. There are many factors associated with postoperative pain. In the literature, there are factors whose relationship could not be determined clearly in the guidelines prepared for this. A meta-analysis showed that TAPP was associated with less chronic pain than open hernia repair. In another study, it was reported that hernia size and type were unrelated to pain. In the same study, the relationship between preoperative pain and postoperative pain was examined. Etele et al. reported that mesh fixation may increase pain. It is thought that the determination of these multiple predictive factors will both guide postoperative pain management and strengthen patient communication. As a result of the research, it is planned to obtain results related to the factors affecting the postoperative pain.

Interventions

• Procedure: transabdominal preperitoneal hernia repair
  • It is made through 3 holes, 10 mm optical port from the umbilicus, and 5 mm ports each from the right and left lower quadrants. The peritoneum is opened a few cm above the defect in the form of an arc. Dissection of the peritoneum, first lateral and then medial to the defect, is performed. It is continued until the pubic bone is found medially and the periphery of the bone is released. The dissection of the cord elements and the sac is completed. Posterior dissection is a very important step to avoid recurrence. Here, the peritoneum is thoroughly dissected posteriorly, the ductus deferens and vessels are removed from the peritoneum so that no recurrence occurs under the patch. 1-2 to the pubic tubercle, 3-5 to the upper edge of the patch, to the upper edge. Staples at the upper edge should remain above the iliopubic tract, no staples should be placed below. The patch is closed by overlapping the peritoneal leaves so that the patch is not visible.

Arms, Groups and Cohorts

• patients with postoperative pain
  • Patients with postoperative pain after transabdominal preperitoneal hernia repair
• patients without postoperative pain
  • Patients without postoperative pain after transabdominal preperitoneal hernia repair

Clinical Trial Outcome Measures

Primary Measures

• postoperative pain
  • Time Frame: one month
  • Factors associated with postoperative pain in patients undergoing transabdominal preperitoneal hernia repair due to inguinal hernia will be investigated. A visual analogue scale (VAS) will be used for postoperative pain. Patients will use this scale to score from 0 (no pain) to 10 (worst possible pain) according to their pain status.

Participating in This Clinical Trial

Inclusion Criteria

• Patients undergoing TAPP for inguinal hernia for the first time Exclusion Criteria:

• Patients under 18 years of age – Patients undergoing open hernia repair – Patients converted from laparoscopic to open – Patients who are pregnant or likely to become pregnant – Patients who cannot comply with the treatment or give their own consent for treatment due to their mental state

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

• Lead Sponsor
  • Tepecik Training and Research Hospital
• Provider of Information About this Clinical Study
  • Principal Investigator: Korhan TUNCER, General Surgeon – Tepecik Training and Research Hospital
• Overall Official(s)
  • Korhan Tuncer, MD, Principal Investigator, Tepecik Training and Research Hospital
• Overall Contact(s)
  • Korhan Tuncer, MD, +905053746812, korhantuncer19@gmail.com

Citations Reporting on Results

Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B, Gockel I. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair – A systematic review and meta-analysis of randomized controlled trials. BMC Surg. 2017 May 10;17(1):55. doi: 10.1186/s12893-017-0253-7.

Tolver MA, Rosenberg J, Bisgaard T. Early pain after laparoscopic inguinal hernia repair. A qualitative systematic review. Acta Anaesthesiol Scand. 2012 May;56(5):549-57. doi: 10.1111/j.1399-6576.2011.02633.x. Epub 2012 Jan 19.

Etele EE, Neagoe RM, Marton D, Sala D, Torok A. Influence of Mesh Fixation on the Development of Postoperative Pain after Laparoscopic Inguinal Hernia Repair: A Single Surgeon Experience. Chirurgia (Bucur). 2020 Sept-Oct;115(5):609-617. doi: 10.21614/chirurgia.115.5.609.