Abstract
Introduction
Despite inguinal hernia repair being one of the most common elective operations performed in general surgical practice, there are many controversies including indications for repair and selection of the surgical technique. In recent years, laparoscopic repair has gained wider acceptance because it is associated with fewer postoperative complications and less chronic pain when compared with conventional approaches with similar recurrence rate. However, patients with lower abdominal surgery are contraindicated for laparoscopic approach. There are few studies that evaluated whether patients who have been subjected to radical prostatectomy might be subjected to laparoscopic hernia repair with the same benefits as those without previous radical prostatectomy.
Methods
Between March 2010 and March 2013, 20 consecutive patients, who had been subjected to prior radical prostatectomy, underwent laparoscopic transabdominal inguinal repair and were followed prospectively. Surgical procedure was performed using a standard technique.
Results
Mean operative time was 67.5 min. There was only one (5 %) intraoperative minor complication, an injury to the inferior epigastric vessels, which was managed by clipping of the vessels. There were no major postoperative complications. After 24 h and on the seventh postoperative day, 85 and 90 % of patients had no pain or only complained of discomfort, respectively. Nine patients (45 %) did not need any analgesics postoperatively. The mean time to return to leisure activities and to work was 3.1 and 5.6 days, respectively. There was no conversion to open surgery. All patients were discharged within 24 h. After a mean follow-up of 14 months, none of the patients presented recurrence.
Conclusion
TAPP after prostatectomy is safe and effective. It seems that patients undergoing laparoscopic repair after radical prostatic resection have the same benefits as those without prostatectomy.
Similar content being viewed by others
References
LeBlanc K (2003) Hernias: inguinal and incisional. Lancet 362:1561–1571
Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193
Stoppa RE, Warlaumont CR, Verhaeghe PJ, Romero ER, M’Balla-N’Di CJ (1986) Prosthetic repair in the treatment of groin hernias. Int Surg 71:154–158
Gong K, Zhang N, Lu Y, Zhu B, Zhang Z, Du D, Zhao X, Jiang H (2011) Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 25:234–239
Eklund A, Montgomery A, Bergkvist L, Rudberg C, Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy (SMIL) Study Group (2010) Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 97:600–608
Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403
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 25:2773–2843
Heikkinen TJ, Haukipuro K, Koivukangas P, Hulkko A (1998) A prospective randomized outcome and cost comparison of totally extra-peritoneal endoscopic hernioplasty versus Lichtenstein operation among employed patients. Surg Laparosc Endosc 8:338–344
Lal P, Kajla RK, Chander J, Saha R, Ramteke VK (2003) Randomised controlled study of total extra-peritoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc 17:850–856
Barrat C, Surlin V, Bordia A, Champault G (2003) Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia 7:125–129
Sayad P, Ferzli G (1999) Laparoscopic preperitoneal repair of recurrent inguinal hernias. J Laparoendosc Adv Surg Tech A 127–130
Mellinger JD, Felix EL (2004) Primary inguinal hernia repair open or laparoscopic, that is the question. Surg Endosc 18:1144–1148
Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant AM (2005) Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev (1)
Shpitz B, Lansberg L, Bugayer N, Tiomkin V, Klein E (2004) Should peritoneal tears be routinely closed during laparoscopic total extraperitoneal repair of inguinal hernias? A reappraisal. Surg Endosc 18:1771–1773
Palanivelu C (2004) Operative manual of laparoscopic hernia surgery (totally extraperitoneal hernioplasty). GEM Foundation, India, pp 99–117
Winslow ER, Quasebarth M, Brunt LM (2004) Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc 18:221–227
Dulucq JL, Wintringer P, Mahajna A (2006) Totally extraperitoneal (TEP) hernia repair after radical prostatectomy or previous lower abdominal surgery: is it safe? A prospective study. Surg Endosc 20:473–476
Wauschkuhn CA, Schwarz J, Bittner R (2009) Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases. Surg Endosc 23:973–977
Tolver MA, Strandfelt P, Forsberg G, Hjørne FP, Rosenberg J, Bisgaard T (2012) Determinants of a short convalescence after laparoscopic transabdominal preperitoneal inguinal hernia repair. Surgery 151:556–563
O’Reilly EA, Burke JP, O’Connell PR (2012) A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Ann Surg 255:846–853
Stolzenburg JU, Anderson C, Rabenalt R, Do M, Ho K, Truss MC (2005) Endoscopic extraperitoneal radical prostatectomy in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol 23:295–299
Do HM, Turner K, Dietel A, Wedderburn A, Liatsikos E, Stolzenburg JU (2011) Previous laparoscopic inguinal hernia repair does not adversely affect the functional or oncological outcomes of endoscopic extraperitoneal radical prostatectomy. Urology 77:963–967
Haifler M, Benjamin B, Ghinea R, Avital S (2012) The impact of previous laparoscopic inguinal hernia repair on radical prostatectomy. J Endourol 26:1458–1462
Vijan SS, Wall JC, Greenlee SM, Farley DR (2008) Consequences of endoscopic inguinal hernioplasty with mesh on subsequent open radical prostatectomy. Hernia 12:415–419
Zhu S, Zhang H, Xie L, Chen J, Niu Y (2013) Risk factors and prevention of inguinal hernia after radical prostatectomy: a systematic review and meta-analysis. J Urol 189:884–890
Conflict of interest
C C. declares no conflict of interest. J.C. declares no conflict of interest. A.C. declares no conflict of interest. A.C.F. declares no conflict of interest. M.L. declares no conflict of interest. D.D. declares no conflict of interest. E.B. declares no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Claus, C.M.P., Coelho, J.C.U., Campos, A.C.L. et al. Laparoscopic inguinal hernioplasty after radical prostatectomy: is it safe? Prospective clinical trial. Hernia 18, 255–259 (2014). https://doi.org/10.1007/s10029-013-1204-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-013-1204-6