Top

Surgical Endoscopy

Published in:

01-05-2021 | Seroma

Modified port positions for totally extraperitoneal (TEP) repair for groin hernias: our experience

Authors: Sarfaraz J. Baig, Pallawi Priya, Anmol Ahuja

Published in: Surgical Endoscopy | Issue 5/2021

Abstract

Background

Totally extraperitoneal repair (TEP) is the preferred method of inguinal hernia repair for many surgeons worldwide. However, because of limited working space, there may be difficulties when operating on large and irreducible groin hernias and short stature patients. There are many ways in which the port positions can be modified during TEP for different kinds of hernias and according to the comfort of the surgeons.

Methods

This is a retrospective analysis of prospectively collected data. We describe two different variations in port placement for TEP in patients with large irreducible hernias and short stature patients.

Results

A total of 19 procedures were performed with these port positions. Most of these were large irreducible hernias or patients with short stature. With these modified port positions, difficult hernias could be completed with extraperitoneal approach. We had no recurrence and 5 seromas that eventually settled in 1–3 months.

Conclusion

Modified port positions in TEP by shifting the ports farther away can be useful for hernias where the surgery is difficult due to limited working space and is a good alternative to TAPP.

Daes J (2012) The enhanced view—totally extraperitoneal technique for repair of inguinal hernia. Surg Endosc 26:1187–1189. https://doi.org/10.1007/s00464-011-1993-6CrossRefPubMed

Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, Buhck H, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Grimes KL, Klinge U, Koeckerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Chowbey P (2015) Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc 29:289–321. https://doi.org/10.1007/s00464-014-3917-8CrossRefPubMed

Saggar VR, Sarangi R (2005) Endoscopic totally extraperitoneal repair of incarcerated inguinal hernia. Hernia 9:120–124. https://doi.org/10.1007/s10029-004-0290-xCrossRefPubMed

Köckerling F (2019) TEP for elective primary unilateral inguinal hernia repair in men: what do we know? Hernia 23:439–459CrossRef

Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Pass C, Singh K, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 32:2773–2843CrossRef

Choi YY, Kim Z, Hur KY (2011) Transection of the hernia sac during laparoscopic totally extraperitoneal inguinal hernioplasty: is it safe and feasible? J Laparoendosc Adv Surg Tech 21:149–152. https://doi.org/10.1089/lap.2010.0237CrossRef

Sanford Z, Weltz AS, Singh D, Hanley R, Todd D, Belyansky I (2019) Minimally invasive multidisciplinary approach to chronic giant inguinoscrotal hernias. Surg Innov 26:427–431. https://doi.org/10.1177/1553350619828888CrossRefPubMed

Daes J (2019) Enhanced view-totally extraperitoneal approach (eTEP) access in hernia repair. Cir Esp 98(5):249–250CrossRef

Ng SC, Lau SYC, Wardill D (2019) How to do an extended totally extraperitoneal mesh repair for groin hernias. ANZ J Surg 89:1324–1325. https://doi.org/10.1111/ans.15456CrossRefPubMed

10.

Zendejas B, Onkendi EO, Brahmbhatt RD, Greenlee SM, Lohse CM, Farley DR (2011) Contralateral metachronous inguinal hernias in adults: role for prophylaxis during the TEP repair. Hernia 15:403–408. https://doi.org/10.1007/s10029-011-0784-2CrossRefPubMed

11.

Uchida H, Matsumoto T, Ijichi H, Endo Y, Koga T, Takeuchi H, Kusumoto T, Muto Y, Kitano S (2010) Contralateral occurrence after laparoscopic total extraperitoneal hernia repair for unilateral inguinal hernia. Hernia 14:481–484. https://doi.org/10.1007/s10029-010-0690-zCrossRefPubMed

12.

Lee CH, Chiu YT, Cheng CF, Wu JC, Yin WY, Chen JH (2017) Risk factors for contralateral inguinal hernia repair after unilateral inguinal hernia repair in male adult patients: analysis from a nationwide population based cohort study. BMC Surg 17:106. https://doi.org/10.1186/s12893-017-0302-2CrossRefPubMedPubMedCentral

Title: Modified port positions for totally extraperitoneal (TEP) repair for groin hernias: our experience
Authors: Sarfaraz J. Baig
Pallawi Priya
Anmol Ahuja
Publication date: 01-05-2021
Publisher: Springer US
Keywords: Seroma
Inguinal Hernia
Published in: Surgical Endoscopy / Issue 5/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07620-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Modified port positions for totally extraperitoneal (TEP) repair for groin hernias: our experience

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2021

Extended View: Totally Extra Peritoneal (e-TEP) Approach for Ventral and Incisional Hernia—Early results from a single center

Impact of pelvic dimensions on anastomotic leak after anterior resection for patients with rectal cancer

Low rate of recurrent bleeding after double-balloon endoscopy-guided therapy in patients with overt obscure gastrointestinal bleeding

Monopolar stray energy in robotic surgery

Work-system interventions in robotic-assisted surgery: a systematic review exploring the gap between challenges and solutions

Impact of perioperative aspirin continuation on bleeding complications in laparoscopic colorectal cancer surgery: a propensity score-matched analysis