Skip to main content
SpringerLink
Log in

Feasibility and safety of total extraperitoneal inguinal hernia repair after previous lower abdominal surgery: a case–control study

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

This study aimed to evaluate the feasibility and safety of totally extraperitoneal (TEP) endoscopic hernia surgery after previous lower abdominal surgery, which may preclude preperitoneal dissection.

Methods

All 331 consecutive patients undergoing TEP surgery between January 2008 and December 2010 were included in a prospective cohort study. This case–control study included a study group and a comparison group. The study group consisted of 23 patients with a history of previous lower abdominal surgery before undergoing TEP endoscopic hernia repair. For the comparison group, 46 patients were randomly selected (two for every patient in the study group) and matched with the study cohort in terms of age, gender, and laterality of inguinal hernia. Perioperative data were obtained for all the patients including demographic data, operation time, length of hospital stay, narcotic dose, conversions, and complications.

Results

A total of 69 patients with inguinal hernias underwent TEP surgery: 23 patients with previous abdominal surgery (study group) and 46 patients without such surgery (control group). No conversions were necessary in the control group, but one case (4.4%) in the study group was converted to transabdominal preperitoneal hernia repair (TAPP) (P = 0.33). Peritoneal injury requiring intracorporeal repair was encountered in six study group patients and eight control group patients (P = 0.53). No differences were observed between the two groups in terms of operative times, analgesic use, hospital stay, return to daily activities, or postoperative complications.

Conclusions

In experienced hands, TEP hernia repair for patients with previous lower abdominal surgery can be performed safely. In this study, the operative outcomes were comparable with those for patients who had no history of lower abdominal surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dulucq JL, Wintringer P, Mahajna A (2009) Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc 23:482–486

    Article  PubMed  Google Scholar 

  2. Dulucq JL, Wintringer P, Mahajna A (2006) Totally extraperitoneal (TEP) hernia repair after radical prostatectomy or previous lower abdominal surgery: Is it safe? A prospective study. Surg Endosc 20:473–476

    Article  PubMed  Google Scholar 

  3. Langeveld HR, Van’t Riet M, Weidema WF, Stassen LP, Steyerberg EW, Lange J, Bonjer HJ, Jeekel J (2010) Total extraperitoneal inguinal hernia repair compared with Lichtenstein (the LEVEL-Trial): a randomized controlled trial. Ann Surg 251:819–824

    Article  PubMed  Google Scholar 

  4. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR (2009) Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up. Ann Surg 249:33–38

    Article  PubMed  Google Scholar 

  5. Fitzgibbons RJ, Camps J, Cornet DA (1995) Laparoscopic inguinal herniorrhaphy: results of a multicenter trial. Ann Surg 221:3–13

    Article  PubMed  Google Scholar 

  6. Gong K, Zhang N, Lu Y, Zhu B, Zhang Z, Du D, Zhao X, Jiang H (2011) Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 25:234–239

    Article  PubMed  Google Scholar 

  7. Myers E, Browne KM, Kavanagh DO, Hurley M (2010) Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg 34:3059–3064

    Article  PubMed  Google Scholar 

  8. Eklund A, Montgomery A, Bergkvist L, Rudberg C, Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy (SMIL) Study Group (2010) Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 97:600–608

    Article  PubMed  CAS  Google Scholar 

  9. Lal P, Kajla RK, Chander J, Saha R, Ramteke VK (2003) Randomised controlled study of total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc 17:850–856

    Article  PubMed  Google Scholar 

  10. Shpitz B, Lansberg L, Bugayer N, Tiomkin V, Klein E (2004) Should peritoneal tears be routinely closed during laparoscopic total extraperitoneal repair of inguinal hernias? Reappraisal. Surg Endosc 18:1771–1773

    Article  PubMed  CAS  Google Scholar 

  11. Paterson HM, Casey JJ, Nixon SJ (2005) Totally extraperitoneal laparoscopic hernia repair in patients with previous lower abdominal surgery. Hernia 9:228–230

    Article  PubMed  CAS  Google Scholar 

  12. Al-Sahaf O, Al-Azawi D, Fauzi MZ, Cunningham FO, McGrath JP (2008) Totally extraperitoneal laparoscopic inguinal hernia repair is a safe option in patients with previous lower abdominal surgery. J Laparoendosc Adv Surg Tech A 18:353–356

    Article  PubMed  Google Scholar 

  13. Ramshaw BJ, Tucker J, Duncan T et al (1996) The effect of previous lower abdominal surgery on performing the total extraperitoneal approach to laparoscopic herniorrhaphy. Am Surg 62:292–294

    PubMed  CAS  Google Scholar 

Download references

Disclosures

Shiu-Dong Chung, Chao-Yuan Huang, Shih-Chieh Chueh, Yao-Chou Tsai, and Hong-Jeng Yu have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan

    Shiu-Dong Chung

  2. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

    Shiu-Dong Chung, Chao-Yuan Huang, Shih-Chieh Chueh & Hong-Jeng Yu

  3. Cleveland Clinic, Glickman Urologic and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA

    Shih-Chieh Chueh

  4. Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan

    Yao-Chou Tsai

  5. Department of Urology, Tzu Chi University, Medical College, Hualien, Taiwan

    Yao-Chou Tsai

  6. Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan

    Yao-Chou Tsai

Authors
  1. Shiu-Dong Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chao-Yuan Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shih-Chieh Chueh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yao-Chou Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hong-Jeng Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yao-Chou Tsai.

Additional information

S. D. Chung and C. Y. Huang contributed this work equally.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chung, SD., Huang, CY., Chueh, SC. et al. Feasibility and safety of total extraperitoneal inguinal hernia repair after previous lower abdominal surgery: a case–control study. Surg Endosc 25, 3353–3356 (2011). https://doi.org/10.1007/s00464-011-1724-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-011-1724-z

Keywords

Search

Navigation