J Korean Surg Soc.  2010 Jun;78(6):405-409. 10.4174/jkss.2010.78.6.405.

The Feasibility of Laparoscopic Total Extraperitoneal (TEP) Herniorrhaphy after Previous Lower Abdominal Surgery

• Park JH
• Choi YY
• Hur KY

• KMID: 2211972
• DOI: http://doi.org/10.4174/jkss.2010.78.6.405

Abstract

PURPOSE
We retrospectively reviewed the medical records to estimate the feasibility and surgical outcome of laparoscopic herniorrhaphies in patients with previous lower abdominal surgery.
METHODS
Between December 2000 and December 2008, a total of 1,101 cases of laparoscopic herniorrhaphies were performed in 974 patients, among them 47 cases (4.27%) of laparoscopic herniorrhaphy in 40 patients who had undergone previous lower abdominal surgery were enrolled to this study.
RESULTS
Most patients (23 of 24) who had a history of appendectomy successfully underwent laparoscopic totally extraperitoneal (TEP) repair. Six patients who had history of a prostatectomy and 2 patients with a Pfannenstiel incision underwent an intraperitoneal only mesh (IPOM) repair after a failed TEP repair. Five patients had lower midline incisions due to panperitonitis, among them TEP repairs were performed in 3 patients and IPOM was performed after failed TEP repairs in 2 patients who had undergone surgery due to trauma-induced rupture of the bladder.
CONCLUSION
Laparoscopic TEP hernia repair could be possible and reasonable in patients after an appendectomy; however, it is difficult in patients with previous pelvic surgeries. Additional studies are needed to determine whether or not laparoscopic TEP repair for inguinal hernias is feasible in patients who have undergone other general surgical procedures.

Keyword

Laparoscopy; Operative scar; Lower abdominal surgery; Inguinal hernia

MeSH Terms

Appendectomy
Hernia, Inguinal
Herniorrhaphy
Humans
Laparoscopy
Medical Records
Prostatectomy
Pyrazines
Retrospective Studies
Rupture
Urinary Bladder
Pyrazines

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