Skip to main content
Log in

Laparoscopic inguinal hernioplasty after radical prostatectomy: is it safe? Prospective clinical trial

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. LeBlanc K (2003) Hernias: inguinal and incisional. Lancet 362:1561–1571

    Article  PubMed  Google Scholar 

  2. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193

    Article  PubMed  CAS  Google Scholar 

  3. 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

    PubMed  CAS  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Article  PubMed  CAS  Google Scholar 

  6. 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

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  7. 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

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  8. 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

    Article  PubMed  CAS  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. Barrat C, Surlin V, Bordia A, Champault G (2003) Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia 7:125–129

    Article  PubMed  CAS  Google Scholar 

  11. Sayad P, Ferzli G (1999) Laparoscopic preperitoneal repair of recurrent inguinal hernias. J Laparoendosc Adv Surg Tech A 127–130

  12. Mellinger JD, Felix EL (2004) Primary inguinal hernia repair open or laparoscopic, that is the question. Surg Endosc 18:1144–1148

    PubMed  CAS  Google Scholar 

  13. 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)

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. Palanivelu C (2004) Operative manual of laparoscopic hernia surgery (totally extraperitoneal hernioplasty). GEM Foundation, India, pp 99–117

    Google Scholar 

  16. 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

    Article  PubMed  CAS  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

  22. 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

    Article  PubMed  Google Scholar 

  23. 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

    Article  PubMed  Google Scholar 

  24. 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

    Article  PubMed  CAS  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

Download references

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

Authors

Corresponding author

Correspondence to C. M. P. Claus.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-013-1204-6

Keywords

Navigation