Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach

Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of...

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Autores principales:	Tuhin Shah, S Shah, BR Joshi, RJ Karkee, RK Gupta
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	Inguino-scrotal hernia Total extraperitoneal hernia repair Laparoscopy Surgery RD1-811
Acceso en línea:	https://doaj.org/article/6e997ebc9170493ab38197d1881210c0
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spelling	oai:doaj.org-article:6e997ebc9170493ab38197d1881210c02021-12-05T19:16:31ZTotal extraperitoneal approach in large inguino-scrotal hernias: an institutional approach10.3126/jssn.v18i3.153131815-39842392-4772https://doaj.org/article/6e997ebc9170493ab38197d1881210c02016-07-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/15313https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of large inguino-scrotal raises objection to laparoscopic procedure because of anticipated problems and complications in dissecting extended hernia sac even though posterior approach is advocated as repair of choice for complicated cases. Here, we reviewed our series of patients undergoing TEP in a limited time frame. Method: Between March 2013 and June 2014, 50 consecutive patients underwent TEP repair for inguinoscrotal hernia. Patient demographics, hernia characteristics, operating time, surgical technique, conversion rate, intraoperative, postoperative complications and recurrence was recorded and analyzed using MS Excel. Results: 50 patients were recorded, 26 had unilateral and 24 had bilateral hernias. Mean age was 52 (22-72) years. The mean operation time was 70 (50-140) min. Bilateral repairs took 45% (18 min) longer than for unilateral repairs (52 + 12 min). Two (12.5%) patients required combined open surgery to transect the incarcerated omentum. There was no mortality. Morbidity was limited to asymptomatic seroma formation in 2 (12.5%) patients; 1 patient of combined open-TEP approach had wound infection, both treated conservatively. Mean follow up was 6.3 months; we recorded 2 recurrences (12.5%). The mean length of hospital stay was 1.8 days. Conclusion: We conclude that TEP can be safely employed for complicated inguinal hernias repair. Surgical experience in mandatory with tailored technique to reduce morbidity and achieve good clinical outcome with acceptable recurrence rates. Tuhin ShahS ShahBR JoshiRJ KarkeeRK GuptaSociety of Surgeons of NepalarticleInguino-scrotal herniaTotal extraperitoneal hernia repairLaparoscopySurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Inguino-scrotal hernia Total extraperitoneal hernia repair Laparoscopy Surgery RD1-811
spellingShingle	Inguino-scrotal hernia Total extraperitoneal hernia repair Laparoscopy Surgery RD1-811 Tuhin Shah S Shah BR Joshi RJ Karkee RK Gupta Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
description	Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of large inguino-scrotal raises objection to laparoscopic procedure because of anticipated problems and complications in dissecting extended hernia sac even though posterior approach is advocated as repair of choice for complicated cases. Here, we reviewed our series of patients undergoing TEP in a limited time frame. Method: Between March 2013 and June 2014, 50 consecutive patients underwent TEP repair for inguinoscrotal hernia. Patient demographics, hernia characteristics, operating time, surgical technique, conversion rate, intraoperative, postoperative complications and recurrence was recorded and analyzed using MS Excel. Results: 50 patients were recorded, 26 had unilateral and 24 had bilateral hernias. Mean age was 52 (22-72) years. The mean operation time was 70 (50-140) min. Bilateral repairs took 45% (18 min) longer than for unilateral repairs (52 + 12 min). Two (12.5%) patients required combined open surgery to transect the incarcerated omentum. There was no mortality. Morbidity was limited to asymptomatic seroma formation in 2 (12.5%) patients; 1 patient of combined open-TEP approach had wound infection, both treated conservatively. Mean follow up was 6.3 months; we recorded 2 recurrences (12.5%). The mean length of hospital stay was 1.8 days. Conclusion: We conclude that TEP can be safely employed for complicated inguinal hernias repair. Surgical experience in mandatory with tailored technique to reduce morbidity and achieve good clinical outcome with acceptable recurrence rates.
format	article
author	Tuhin Shah S Shah BR Joshi RJ Karkee RK Gupta
author_facet	Tuhin Shah S Shah BR Joshi RJ Karkee RK Gupta
author_sort	Tuhin Shah
title	Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
title_short	Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
title_full	Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
title_fullStr	Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
title_full_unstemmed	Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
title_sort	total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/6e997ebc9170493ab38197d1881210c0
work_keys_str_mv	AT tuhinshah totalextraperitonealapproachinlargeinguinoscrotalherniasaninstitutionalapproach AT sshah totalextraperitonealapproachinlargeinguinoscrotalherniasaninstitutionalapproach AT brjoshi totalextraperitonealapproachinlargeinguinoscrotalherniasaninstitutionalapproach AT rjkarkee totalextraperitonealapproachinlargeinguinoscrotalherniasaninstitutionalapproach AT rkgupta totalextraperitonealapproachinlargeinguinoscrotalherniasaninstitutionalapproach
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Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach

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