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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
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Total extraperitoneal preperitoneal laparoscopic hernia repair using spinal anesthesia.

Bruce M Molinelli1, Alfonso Tagliavia, David Bernstein

  • 1Department of Surgery, Greenwich Hospital, Yale New Haven Health System, Greenwich, Connecticut, USA. SSG06830@Hotmail.com

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|January 11, 2007
PubMed
Summary

Spinal anesthesia is a safe and effective option for laparoscopic inguinal hernia repair. This study found it to be a feasible and preferable anesthesia method for total extraperitoneal preperitoneal (TEP) repairs.

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Area of Science:

  • Surgical Anesthesiology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic inguinal hernia repair is debated, with anesthesia choice being a key variable.
  • No prior reports exist on spinal anesthesia use for laparoscopic hernia repair.
  • This study reviews spinal anesthesia for total extraperitoneal preperitoneal (TEP) laparoscopic hernia repair.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of spinal anesthesia for TEP laparoscopic hernia repair.
  • To compare spinal anesthesia with other anesthesia methods in TEP procedures.

Main Methods:

  • Prospective review of 30 patients undergoing TEP under spinal anesthesia.
  • Analysis of anesthesia methods, surgical procedure, operative/anesthesia times, and patient outcomes.
  • 2-year follow-up for short- and long-term results.

Main Results:

  • Successful TEP laparoscopic hernia repair in all 30 patients under spinal anesthesia.
  • 44 hernias repaired without conversion to general anesthesia.
  • No significant adverse effects from spinal anesthesia at short- or long-term follow-up; 3 patients experienced transient inguinodynia.

Conclusions:

  • Spinal anesthesia is a feasible method for TEP laparoscopic hernia repair.
  • In this experience, spinal anesthesia is the preferable anesthesia choice for TEP.
  • The procedure demonstrates a favorable safety profile with minimal complications.