Femoral vessel blood flow dynamics following totally extraperitoneal vs Stoppa procedure in bilateral inguinal hernias.
BACKGROUND
Both totally extraperitoneal (TEP) and open preperitoneal (Stoppa) procedures involve the placement of prosthetic material preperitoneally. Because the prosthetic material overlies the femoral artery and vein, the aim of this study was to assess its effect on the velocities and diameters of the artery and vein using color Doppler ultrasonography in both approaches.


METHODS
Sixty-four patients with bilateral groin hernias were prospectively randomized to undergo either TEP (n = 32) or Stoppa (n = 32) repair. All patients underwent color Doppler ultrasound 6 months after the procedures, and the median follow-up period was 18 months.


RESULTS
Neither mean diameter nor mean flow velocity was changed by the insertion of the mesh preperitoneally. The only change was observed in peak systolic femoral arterial blood velocity, which was significantly decreased in the Stoppa group. Also, no patient in this study developed clinically significant deep venous thrombosis during 6 months of follow-up.


CONCLUSIONS
The insertion of a prosthetic mesh during TEP and Stoppa procedures does not influence the mean peak flow velocities and cross-sectional areas of the vessels in the inguinal region and can be used safely for open and laparoscopic preperitoneal approaches.
Ozmen
Mahir
M
Department of Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey. mahir.ozmen@tubitak.gov.tr
Zulfikaroglu
Baris
B
Ozalp
Necdet
N
Moran
Munevver
M
Soydinc
Perihan
P
Ziraman
Ipek
I
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013526:Surgical Mesh / Q000009:adverse effects; D018615:Ultrasonography, Doppler, Color