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Totally extraperitoneal (TEP) endoscopic hernia repair in elderly patients

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Abstract

Background

Inguinal hernias are common in elderly males. We addressed outcome following totally extraperitoneal (TEP) hernia repair in patients older than 70 years.

Methods

We prospectively collected data of patients >70 years with a unilateral or bilateral inguinal hernia operated in our hospital between January 2005 and January 2010 using the TEP technique.

Results

A total of 429 patients underwent TEP hernia repair under general anaesthesia, mostly men (n = 405; 94.4 %). Median age was 74 years (range 70–89). The mean pre-operative pain score was 3.7 (SD ± 2.5). Ninety-four percent of patients had an ASA score of 1 or 2. Three hundred thirty-six patients underwent a unilateral repair (78 %). The conversion rate to an anterior procedure was 0.7 % (n = 3). In 8 patients (1.9 %), intra-operative complications occurred, and the postoperative course was complicated in 3 patients (0.7 %). Severe complications attributable to the endoscopic approach occurred in 6 patients (1.4 %): a bladder injury (n = 5) and a trocar-induced bowel perforation (n = 1). The mean postoperative pain score after 6 weeks was 1.6 (SD ± 1.2). Patients were able to resume their daily activities after a median of 7 days (range 1–42).

Conclusion

Totally, extraperitoneal endoscopic inguinal hernia repair in elderly patients is associated with low overall complication rates and a fast recovery. In a small proportion of patients, severe complications occur attributable to the endoscopic approach.

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Authors and Affiliations

  1. Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands

    C. E. H. Voorbrood, J. P. J. Burgmans, G. J. Clevers, P. H. P. Davids, E. J. M. M. Verleisdonk & T. van Dalen

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  1. C. E. H. Voorbrood
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  2. J. P. J. Burgmans
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  3. G. J. Clevers
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  4. P. H. P. Davids
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  5. E. J. M. M. Verleisdonk
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  6. T. van Dalen
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Correspondence to C. E. H. Voorbrood.

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Disclosure

C.E.H. Voorbrood, J.P.J. Burgmans, G.J. Clevers, P.H.P. Davids, E.J.M.M. Verleisdonk and T. van Dalen certify that they have no commercial associations (e.g. consultancies, stock ownership, equity interests, patent-licencing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. A Research Grant has been assigned to the Diakonessenhuis/Hernia Centre Zeist by Johnson & Johnson to partially support all research regarding the endoscopic totally extraperitoneal hernia repair.

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Voorbrood, C.E.H., Burgmans, J.P.J., Clevers, G.J. et al. Totally extraperitoneal (TEP) endoscopic hernia repair in elderly patients. Hernia 19, 887–891 (2015). https://doi.org/10.1007/s10029-015-1422-1

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  • DOI: https://doi.org/10.1007/s10029-015-1422-1

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