title: Totally extraperitoneal laparoscopic inguinal hernia repair using a self-expanding nitinol framed hernia repair device: A prospective case series.
abstract: BACKGROUND
  The use of a self-expanding nitinol framed prosthesis (ReboundHRD®) for totally extraperitoneal laparoscopic inguinal hernia repair (TEP-IHR) could solve issues of mesh shrinkage and associated pain. We prospectively evaluated the use of the ReboundHRD®mesh for TEP-IHR.
  
  
  METHODS
  All patients who underwent a TEP-IHR using the ReboundHRD®Large mesh from April 2014 till May 2015, were included. No mesh fixation was performed. Follow-up assessments were performed at the day of surgery, 1, 2, and 7 days, 1, 3, 6, and 12 months. Outcome measures include post-operative pain (visual analogue scale, VAS), operative details, complications, and recurrence rate.
  
  
  RESULTS
  In total, 69 TEP-IHR procedures were performed in 54 patients (15 bilateral hernias). No perioperative and 5 (9%) postoperative complications occurred, all graded Clavien-Dindo I-II. The median length of stay was 1 day (range 0-3), with 78% of the operations performed in an ambulatory setting. Median VAS score decreased from 3 (range 0-4) on the day of surgery to 1 (range 0-2) on day 7. Patients were completely pain-free at a median time of 5 (range 1-60) days. The majority (80.4%, 37/46) of the active patients went back to work within 2 weeks (maximum 6 weeks). At a median follow-up of 19 months (range 16-26 months), no recurrences occurred.
  
  
  CONCLUSIONS
  TEP-IHR using a self-expanding nitinol framed hernia repair device is a safe technique in longterm follow-up. The technique is associated with a low incidence of postoperative pain, a short hospital stay and quick return to normal activities.
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium. Electronic address: mathieudhondt2000@yahoo.com.
authors.forename: Mathieu
authors.initials: M
authors.lastname: D'Hondt
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium.
authors.forename: Frederiek
authors.initials: F
authors.lastname: Nuytens
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium.
authors.forename: Emi
authors.initials: E
authors.lastname: Yoshihara
authors.affiliation: Adriaens Consulting Bvba, Bellemdorpweg 95, 9881 Aalter, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Adriaens
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium.
authors.forename: Franky
authors.initials: F
authors.lastname: Vansteenkiste
authors.affiliation: Interdisciplinary Research Center, Katholieke Universiteit Leuven Campus Kortrijk, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Pottel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys / Q000627:therapeutic use*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh / Q000009:adverse effects
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Inguinal hernia; Laparoscopy; Pain; Self expanding device; Totally extraperitoneal hernia repair