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Hernia

, Volume 23, Issue 2, pp 281–286 | Cite as

Laparoscopic transperitoneal inguinal hernioplasty (TAPP) after radical open retropubic prostatectomy: special features and clinical outcomes

  • W. K. J. PeitschEmail author
Original Article
  • 143 Downloads

Abstract

Purpose Laparoscopic transperitoneal endoscopic (TAPP) and totally extraperitoneal (TEP) hernia repair have been well established in primary and recurrent inguinal hernias [1]. Only few studies [2, 3, 4, 5] evaluate the surgical outcome of patients with inguinal hernias after radical prostatectomy, using the TAPP or TEP procedure. But controversies remain including its feasibility, safety and recurrence rate. The mesh size to be used and the necessity of a complete dissection of the scared retropubic space are discussed controversially. Long-term follow-up studies are missing.

Methods After introducing the technique of a laparoscopic transperitoneal endoscopic hernioplasty (TAPP) at the hospital in October 1992, this approach had been recommended to all adult patients with inguinal and femoral hernias. In our single-center study, the medical records of all 5,764 patients with 7,010 inguinal and femoral hernias, operated from 1993 until 2009, were enrolled in a retrospective analysis. A TAPP procedure was performed in 6,582 hernias (Peitsch, Surg Endosc 28:671–682, 2014). During that period, 48 patients with 55 inguinal hernias on average of 3.7 years (3 months–14 years) after prior open radical retropubic prostatectomy underwent hernia surgery (92.7% TAPP). The age of these patients, time required for surgery, hernia location (medial, lateral, combined and bilateral), the perioperative (30-day complications “Clavien Classification”) and late complications with a median postoperative follow-up time of 8.0 years (2–17 years) were analyzed and compared with the data of the control group (all TAPP procedures for inguinal and femoral hernias).

Results Patients with inguinal hernias after radical open retropubic prostatectomy were older as patients of the control group (70.3 vs. 59.1 years) and the medial time required for surgery was significantly longer (72.9 vs. 41.3 min). Less frequent were bilateral inguinal hernias (25.5 vs. 35.8%), medial inguinal hernias (Hernia classification Nyhus Type 3A) with 5.5 vs. 17.9% and femoral hernias (0 vs. 4.9%). No hernia patient after radical prostatectomy and only 0.1% of the control group (n = 6582 hernias) had a conversion to an anterior open repair. One patient after radical prostatectomy needed a laparoscopic drainage of a hemato-seroma 48 h postoperatively (1/51). The rate of late postoperative complications was low. 4.8% of patients reported of groin pain and 2.4% of testicular pain longer than 28 days postoperatively. The hernia recurrence rate of 2.4% (1/42 TAPP) was not significantly different from the control group (1.8%, 16/896 hernias).

Conclusions In the hands of surgeons with large experiences in endoscopic laparoscopic hernia repair, the laparoscopic transperitoneal hernioplasty (TAPP) after previous radical open retropubic prostatectomy is safe and effective with low intra- and postoperative complications and low hernia recurrences (2.4%). A TAPP technique with closure of hernia gaps larger than 1 × 1 cm with non-absorbable surgical sutures and a mesh-size of 13 × 13–15 cm is requested. A complete sharp dissection of the retropubic scared tissue for mesh implantation is not mandatory.

Keywords

Laparoscopic transperitoneal hernia repair TAPP radical open prostatectomy Hernia recurrences 

Notes

Author contributions

WKJP project development, data collection and manuscript writing. WKJP declares no conflict of interest. The manuscript has not been submitted to more than one journal of simultaneous consideration. This manuscript has not been published previously. Only the recurrence rate of a group of hernias with TAPP procedure, operated in 1994, 1999, 2004 and 2009, has been published before [6].

Compliance with ethical standards

Conflict of interest

This study was not funded. WKJP has has not received research and educational grants or consulting fees.

Ethical approval

Ethical approval was agreed by the ethical committee of the Faculty of Medicine at the University of Göttingen, Germany.

Human and animal rights

The study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all individual patients including in the study.

References

  1. 1.
    Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, Buhck H, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Grimes KL, Klinge U, Köckerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Chowbey P. International Endohernia Society (2015) Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc 29:289–321CrossRefGoogle Scholar
  2. 2.
    Dulucq J-L, Wintringer P, Mahajna A (2006) Totally extraperitoneal (TEP) hernia repair after radical prostatectomy or previous lower abdominal surgery. Surg Endosc 20:473–476CrossRefGoogle Scholar
  3. 3.
    Wauschkuhn CA, Schwarz J, Bittner R (2009) Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases. Surg Endosc 23:973–977CrossRefGoogle Scholar
  4. 4.
    Claus CMP, Coelho JCU, Campos ACL, Cury Filho AM, Loureiro MP, Dimbarre D, Bonin EA (2014) Laparoscopic inguinal hernioplasty after radical prostatectomy: is it safe? Prospective clinical trial. Hernia 18:255–259CrossRefGoogle Scholar
  5. 5.
    Sakon M, Sekino Y, Okada M, Seki H, Munakata Y (2017) Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy. Hernia 21:745–748CrossRefGoogle Scholar
  6. 6.
    Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, deLange D, Fortelny R, Heikkinen T, Kingsnorth A et al (2009) European hernia society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403CrossRefGoogle Scholar
  7. 7.
    Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E et al (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society [(IEHS)]. Surg Endosc 25:2773–2843CrossRefGoogle Scholar
  8. 8.
    Zhu S, Zhang H, Xie L, Chen J, Niu Y (2013) Risk factors and prevention of inguinal hernia after radical prostatectomy: a systematic review and meta-analysis. J Urology 189:884–890CrossRefGoogle Scholar
  9. 9.
    Yamada Y, Fujimura T, Fukuhara H, Sugihara T, Takemura K, Kakutani S, Suzuki M, Nakagawa T, Kume H, Igawa Y, Homma Y (2017) Incidence and risk factors of inguinal hernia after robot- assisted radical prostatectomy. World J Surg Oncol 15:61.  https://doi.org/10.1186/s12957-017-1126-3 CrossRefGoogle Scholar
  10. 10.
    Stolzenburg J-U, Rabenalt R, Do M, Kallidonis P, Liatsikos P (2008) Endoscopic extraperitoneal radical prostatectomy: The University of Leipzig experience of 200 cases. J Endourol 22:2319–2325CrossRefGoogle Scholar
  11. 11.
    Coelho RF, Rocco B, Patel MB, Orvieto MA, Chauhan S, Ficarra V, Melagari S, Palmer KJ, Patel VR (2010) Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers. J Endourol 24:2003–2015CrossRefGoogle Scholar
  12. 12.
    Stolzenburg J-U, Anderson C, Rabenalt R, Do M, Ho K, Truss MC (2005) Endoscopic extraperitoneal prostatectomy in patients with prostate cancer and previous laparoscopic inguinal mesh replacement for hernia repair. World J Urol 23:295–299CrossRefGoogle Scholar
  13. 13.
    Peitsch WKJ (2014) A modified laparoscopic hernioplasty (TAPP) is the standard procedure for inguinal and femoral hernias: a retrospective 17-years analysis with 1,123 hernia repairs. Surg Endosc 28:671–682CrossRefGoogle Scholar
  14. 14.
    Bittner R, Arregui ME, Bisgaard T, Dudai M, Herzl GS, Fitzgibbons RI, Fortelny HH, Klinge U, Köckerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Paß C, Singh K, Mimoey M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 25:2773–2843CrossRefGoogle Scholar
  15. 15.
    Miserez M, Peeters E, Aufenacker T, Bouillot J, Campanelli G, Conze J, Fortelny R, Heikkinen T, Jorgensen LN, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Simons MP (2014) Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 18:151–163CrossRefGoogle Scholar
  16. 16.
    HerniaSurgGroup. Simons MP, Aufenacker TJ, Berrevoet F, Bingener J, Bisgaard T, Bittner R, Bonjer HJ, Bury K, Campanelli G, Chen DC, Chowbey PK, Conze J, Cuccurullo D, deBraux AC, Eker HH, Fitzgibbons RJ, Fortelny RH, Gillion JF, van den Heuvel BJ, Hope WW, Jorgensen LN, Klinge U, Köckerling F, Kukleta JF, Konate I, Liem AL, Lomanto D, Loos MJA, Lopez-Cano M, Miserez M, Misra MC, Montgomery A, Morales-Conde S, Muysoms FE, Niebuhr H, Nordin P, Pawlak M, van Ramshorst GH, Reinpold WMJ, Sanders DL, Sani R, Schouten N, Smedberg S, Smietanski M, Simmermacher RKJ, Tran HM, Tumtavitikul S, van Veenendaal N, Weyhe D, Wijsmuller AR (2018) International guidelines for groin hernia management. Hernia 18:1–165CrossRefGoogle Scholar
  17. 17.
    Bittner R, Sakon M, Sekino Y, Okada M, Seki H, Munakata Y (2017) Invited comment to: Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy. Hernia 21:987–988CrossRefGoogle Scholar
  18. 18.
    Vos PM, Simons MP, Luitse JS, van Geldere D, Koelemaij MJ, Obertop H (1998) Follow-up after inguinal hernia repair: questionnaire compared with physical examination: a prospective study in 299 patients. Eur J Surg 164:533–536CrossRefGoogle Scholar
  19. 19.
    Do HM, Turner K, Dietel A, Wedderburn A, Liatsikos E, Stolzenburg J-U (2011) Previous laparoscopic inguinal hernia repair does not adversely affect the functional or oncological outcomes of endoscopic extraperitoneal radical prostatectomy. Urology 77:963–967CrossRefGoogle Scholar
  20. 20.
    Katz EE, Patel RV, Sokoloff MH, Vargish T, Brendler CB (2002) Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. J Urol 167:637–638CrossRefGoogle Scholar
  21. 21.
    Ghazi A. Do HM, Turner K, Dietel A, Wedderburn A, Liatsikos E, Stolzenburg J-U (2011) Editorial comment. Previous laparoscopic inguinal hernia repair does not affect the functional or oncological outcomes of endoscopic extraperitoneal radical prostatectomy. Urology 77:967–968CrossRefGoogle Scholar
  22. 22.
    Do HM. Do HM, Turner K, Dietel A, Wedderburn A, Liatsikos E (2011) Reply. Stolzenburg J-U Previous laparoscopic inguinal hernia repair does not adversely affect the functional or oncological outcomes of endoscopic extraperitoneal radical prostatectomy. Urology 77:968CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General, Visceral, Vascular and Trauma SurgerySt. Josef Hospital Werden, University Medicine EssenEssenGermany

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