Totally Extraperitoneal Repair of Groin Hernia in Liver Transplanted Patients
NCT05378451 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 10
Last updated 2024-03-20
Summary
Liver transplant recipients share the risk with cirrhotic patients for the development of inguinal hernias, but their liver failure pathophysiology has reversed following transplantation. Despite immunosuppression alters wound healing and infections, inguinal hernia repair in transplanted patients has shown better outcome compared to cirrhotic patients. Endoscopic inguinal hernia techniques have proved to be superior to open repair, due to lower incidence of postoperative complications and short-term convalescence, but there is no evidence of the use of this approach in liver transplanted patients. This prospective consecutive case series study will be the first study to describe the postoperative results of groin hernia repair in ambulatory surgery regimen in liver transplanted patients using totally extraperitoneal approach. The included patients will be prospectively registered in a standardized database. Rate of completion of surgery by totally extraperitoneal approach without the needing of conversion to anterior open approach or transabdominal preperitoneal approach due technical difficulties will be evaluated. Postoperative complications all along with quality standards criteria of ambulatory surgery will be reported for descriptive purposes.
Conditions
- Liver Transplant Disorder
- Liver Cirrhosis
- Groin Hernia
Interventions
- PROCEDURE
-
Totally Extraperitoneal Groin Hernia Repair
Patients will undergo totally extraperitoneal groin hernia repair, by a single senior experimented surgeon and without modifications from the routine clinical practice due to study inclusion. TEP approach will be assessed by placement of 3 trocars in the lower midline. Preperitoneal space will be dissected under direct vision using Spacemaker Dissection Balloon (Applied Medical®). Systematic complete dissection of the myopectineal orifice, Retzius and Bogros spaces will be performed to identify all potential sites of hernia formation. It will be used a laparoscopic self-fixating mesh (ProGrip™). Preperitoneal instillation of local anesthesia (15 mL of 0.5% bupivacaine) will be placed placed by the surgeon under direct visualization into "triangle of pain". Local anesthesia (levobupivacaine 10mL 1%) will be applied in all the incisions.
Sponsors & Collaborators
-
Hospital Clinic of Barcelona
lead OTHER
Principal Investigators
-
Paula Dominguez-Garijo, MD · General Surgery, ICMDM, Hospital Clínic de Barcelona.
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2022-05-08
- Primary Completion
- 2023-12-01
- Completion
- 2024-01-01
Countries
- Spain
Study Locations
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