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Surgical Endoscopy

, Volume 25, Issue 7, pp 2147–2152 | Cite as

Laparoscopic repair of suprapubic hernias: transabdominal partial extraperitoneal (TAPE) technique

  • Anil SharmaEmail author
  • Ashish Dey
  • Rajesh Khullar
  • Vandana Soni
  • Manish Baijal
  • Pradeep K. Chowbey
Article

Abstract

Background

Suprapubic hernias are considered difficult to repair laparoscopically due to deficient posterior rectus sheath and proximity to important neurovascular structures and the urinary bladder.

Methods

We retrospectively reviewed 72 patients (18 males, 54 females) who, between 1998 and 2008, had undergone laparoscopic repair for suprapubic hernial defects located less than 5 cm from the pubic arch. Five patients (6.9%) had recurrent hernias. A peritoneal flap was dissected distally to facilitate a mesh overlap of at least 5 cm from the hernial defect. The lower margin of the mesh was fixed under direct vision to Cooper’s ligaments bilaterally. The raised peritoneal flap was reattached to the anterior abdominal wall thereby partially extraperitonealizing the mesh.

Results

Mean diameter of the hernial defect was 5.2 cm (range = 3.1–7.3 cm) as measured intraperitoneally. Mean size of the mesh used was 328.8 cm2 (range = 225–506 cm2). Mean operating time was 116 min (range = 64–170 min). Overall complication rate was 27.8%. There were no conversions. No recurrences were observed at a mean follow-up of 4.8 years (range = 1.2–6.9 years) and a follow-up rate of 84.7%

Conclusion

A mesh overlap of at least 5 cm and fixation of the lower margin of the mesh under direct vision to Cooper’s ligaments appears to confer increased strength and durability and contribute to low hernia recurrence rates in patients with suprapubic hernias.

Keywords

Suprapubic hernia Incisional hernia Laparoscopic incisional onlay mesh repair 

Notes

Disclosures

A. Sharma, A. Dey, R. Khullar, V. Soni, M. Baijal, and P. K. Chowbey have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Anil Sharma
    • 1
    Email author
  • Ashish Dey
    • 2
  • Rajesh Khullar
    • 1
  • Vandana Soni
    • 1
  • Manish Baijal
    • 1
  • Pradeep K. Chowbey
    • 1
  1. 1.Max Institute of Minimal AccessMetabolic and Bariatric Surgery, Max Super Speciality Hospital-East BlockNew DelhiIndia
  2. 2.Department of General SurgerySir Ganga Ram HospitalNew DelhiIndia

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