Totally extraperitoneal laparoscopic hernia repair in patients with previous lower abdominal surgery.

Abstract

INTRODUCTION:

Patients with lower abdominal scars are generally excluded from laparoscopic hernia repair due to the perceived technical difficulty and risk of visceral injury. This study examines the outcome of a series of patients who underwent totally extraperitoneal (TEP) inguinal hernia repair despite previous lower abdominal surgery.

METHODS:

Retrospective review of 47 consecutive patients who underwent TEP inguinal hernia repair in the presence of lower abdominal scars between 1993 and 2002.

RESULTS:

Thirty-five unilateral and 12 bilateral TEP hernia repairs were performed in the presence of 20 appendicectomy, 10 lower midline, 18 suprapubic and 5 paramedian incisions. Two cases were converted to open repair. There were no major complications and no early or late recurrences. Median operating time was 67.5 min and 83% of patients were managed as day cases.

CONCLUSIONS:

Totally extraperitoneal laparoscopic hernia repair can be carried out safely in the presence of scars from previous lower abdominal surgery.

• Authors: H M Paterson, J J Casey, S J Nixon
• Journal: Hernia : the journal of hernias and abdominal wall surgery (Hernia) Vol. 9 Issue 3 Pg. 228-30 (Oct 2005) ISSN: 1265-4906 [Print] France
• PMID: 15976931 (Publication Type: Journal Article)

Topics

• Abdomen (surgery)
• Adult
• Aged
• Aged, 80 and over
• Cicatrix (etiology)
• Contraindications
• Female
• Hernia, Inguinal (surgery)
• Humans
• Laparoscopy
• Male
• Middle Aged
• Postoperative Complications
• Recurrence