Abstract
Background
This review aimed to compare laparoscopic preperitoneal herniorrhaphy (LPPH) using a laryngeal mask airway and local anesthesia with conventional open herniorrhaphy using similar anesthetic conditions.
Methods
A retrospective review of 238 hernia operations was conducted from October 1996 through September 1998. Laparoscopic preperitoneal hernia repairs with the patient under laryngeal mask airway anesthesia were performed initially using 10 ml of 0.5% bupivacaine (LPPH+10 group). This was compared with hernia repair using 30 ml of 0.5% bupivacaine (LPPH+30 group). Both LPPH groups were compared with a plug and patch “Gilbert” hernia repair group. Postoperative pain was compared in the recovery room and outpatient suite.
Results
The LPPH+30 group required significantly less postoperative pain medication than the LPPH+10 group. The LPPH+30 group required slightly more pain medication in the recovery room than the open hernia repair group, but in the postanesthesia care unit (PACU) unit, the LPPH+30 group used less pain medication. A similar number of LPPH+30 patients, and open hernia repair patients required no pain medication.
Conclusions
The use of a long-acting local anesthetic, (30 ml of 0.5% bupivacaine via laryngeal mask airway) for laparoscopic preperitoneal hernia repair compared favorably with conventional open hernia repair using similar anesthetic techniques.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brooks DC (1994) A prospective comparison of laparoscopic and tension-free open herniorraphy. Arch Surg 129: 361–366
Chundrigar T, Hedges AR, Morris R, Stamatakis JD (1993) Intraperitoneal bupivacaine for effective pain relief after laparoscopic chole-cystectomy. Ann R Coll Surg Engl 75: 437–439
Fitzgibbons Jr RJ, Camps J, Cornet DA, Nguyen NX, Litke BS, Annibali R, Salerno GM (1995) Laparoscopic inguinal herniorrhaphy: results of a multicenter trial. Ann Surg 221: 3–13
Ger R, Monroe K, Durivier K, Mishrick A (1990) Management of indirect inguinal hernias by laparoscopic closure of the neck of the sack. Am J Surg 159: 371–373
Gilbert A (1992) Sutureless repair of inguinal hernia. Am J Surg 163: 331–335
Goodwin APL, Rowe WL, Ogg TW (1992) Day case laparoscopy: a comparison of two anaesthetic techniques using the laryngeal mask during spontaneous breathing. Anesthesia 47: 892–895
Kakkis JL, Brunicardi FC (1996) Total exrtraperitoneal laparoscopic hernia repair: a modified technique associated with few complications and a low early recurrence rate. Am Surg 62: 846–848
Kozol R, Lange PM, Kosir M, Beleski K, Mason K, Tennenberg S, Kubinec SM, Wilson RF (1997) A prospective, randomized study of open vs. laparoscopic inguinal hernia repair. Arch Surg 132: 292–295
Liem MSL, Van der Graaf Y, Van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS, Stassen LPS, Vente JP, Weidema WF, Schrijvers AJP, Van Vroonhoven TJMV (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair. N Engl J Med 336: 1541–1547
McKernan JB, Laws HL (1992) Laparoscopic preperitoneal prosthetic repair of inguinal hernias. Surg Rounds 15: 597–610
Moreno-Egea A, Aguayo JL, Canteras M (2000) Intraoperative and postoperative complications of totally extraperitoneal laparoscopic inguinal hernioplasty. Surg Laparosc Endosc 10: 30–33
Mos G, Regal ME, Lichtig L (1986) Reducing postoperative pain, narcotics, and length of hospitalization. Surgery 99: 206–210
Nyhus LM, Condon RE, eds (1978) Hernia. 2nd ed. JB Lippincott, Philadelphia, pp 212–230
O’Riordain DS, Kelly P, Horgan PG, Keane FBV, Tanner WA (1998) A randomized controlled trial of extraperitoneal bupivacaine analgesia in laparoscopic hernia repair. Am J Surg 176: 254–257
Patel JM, Lanzafame RJ, Williams JS, Mullen BV, Hinshaw JR (1983) The effect of incisional infiltration of bupivacaine hydrochloride upon pulmonary functions, atelectasis and narcotic need following elective cholecystectomy. Surg Gynecol Obstet 157: 338–340
Payne JH, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J (2000) Laparoscopic or open inguinal herniorrhaphy? A randomized prospective trial. Arch Surg 129: 973–981
Phillips EH, Carroll BJ, Fallas MJ (1993) Laparoscopic preperitoneal inguinal hernia repair without peritoneal incision: technique and early results. Surg Endosc 7: 159–162
Rademaker BM, Kalkman CJ, Odoom JA, de Wit L, Ringers J (1994) Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effect of postoperative pain, metabolic responses, and lung function. Br J Anaesth 72: 263–266
Ramshaw BJ, Tucker JG, Conner T, Mason EM, Duncan TD, Lucas GW (1996) A comparison of the approaches to laparoscopic herniorrhaphy. Surg Endosc 10: 29–32
Spitz JD, Arregui ME (2000) Sutureless laparoscopic extraperitoneal inguinal herniorrhaphy using reusable instruments: two hundred three repairs without recurrence. Surg Laparosc Endosc 10: 24–29
Stoker DL, Spiegelhalter DJ, Singh R, Wellwood JM (1994) Laparoscopic versus open inguinal hernia repair: randomised prospective trial. Lancet 343: 1243–1245
Vanclooster P, Meersman AL, de Gheldere CA, Van de Ven CK (1996) The totally extraperitoneal laparoscopic hernia repair: preliminary results. Surg Endosc 10: 332–335
Author information
Authors and Affiliations
Additional information
Online publication: 12 June 2001
Rights and permissions
About this article
Cite this article
Edelman, D.S., Misiakos, E.P. & Moses, K. Extraperitoneal laparoscopic hernia repair with local anesthesia. Surg Endosc 15, 976–980 (2001). https://doi.org/10.1007/s004640080102
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s004640080102