Surgical laparoscopy & endoscopy
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Surg Laparosc Endosc · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialLaparoscopic hernia repair: a prospective comparison of TAPP and IPOM techniques.
The aim of the study was to evaluate the safety and efficacy of two techniques of laparoscopic hernia repair: the transabdominal preperitoneal technique (TAPP) and the intraperitoneal onlay mesh technique (IPOM). In May 1992 a prospective randomized trial was initiated to compare TAPP and IPOM. Until October 1994, 115 patients with 148 hernias took part in the trial (59 TAPP and 56 IPOM). ⋯ Neuralgias occurred in 3 cases of TAPP and 11 cases of IPOM (p < 0.05), local hematoma in 6 cases of TAPP and 3 cases of IPOM (NS), and urinary retention in 1 case of TAPP and in no case of IPOM (NS). Recurrences occurred in no cases of TAPP and in 8 cases (11.1% of hernias) of IPOM (p < 0.01). The results of the present report suggest that the IPOM technique for laparoscopic hernia repair should be avoided, whereas TAPP appears to be an excellent technique with no early recurrences.
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Surg Laparosc Endosc · Dec 1997
Review Comparative StudyAppendicitis: laparoscopic versus conventional operation: a study and review of the literature.
A retrospective study was performed after introduction of the laparoscopic technique in patients with suspected appendicitis to validate it in comparison with conventional open appendectomy. A series of 103 patients with suspected acute appendicitis were included. In 51 consecutive patients, a diagnostic laparoscopy was performed, and, if needed, an appendectomy was carried out. ⋯ The postoperative need for analgesia was lower (p < 0.01) and the operation time was longer (p < 0.0001) in the laparoscopic group than the group that underwent open surgery. It can be concluded that the greatest benefits of the laparoscopic technique are that it causes less trauma, the diagnostic accuracy is better, and the cosmetic result is superior to that after a conventional operation. This is all at the price of a longer operation time.