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Modified port positions for totally extraperitoneal (TEP) repair for groin hernias: our experience

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Abstract

Background

Totally extraperitoneal repair (TEP) is the preferred method of inguinal hernia repair for many surgeons worldwide. However, because of limited working space, there may be difficulties when operating on large and irreducible groin hernias and short stature patients. There are many ways in which the port positions can be modified during TEP for different kinds of hernias and according to the comfort of the surgeons.

Methods

This is a retrospective analysis of prospectively collected data. We describe two different variations in port placement for TEP in patients with large irreducible hernias and short stature patients.

Results

A total of 19 procedures were performed with these port positions. Most of these were large irreducible hernias or patients with short stature. With these modified port positions, difficult hernias could be completed with extraperitoneal approach. We had no recurrence and 5 seromas that eventually settled in 1–3 months.

Conclusion

Modified port positions in TEP by shifting the ports farther away can be useful for hernias where the surgery is difficult due to limited working space and is a good alternative to TAPP.

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References

  1. Daes J (2012) The enhanced view—totally extraperitoneal technique for repair of inguinal hernia. Surg Endosc 26:1187–1189. https://doi.org/10.1007/s00464-011-1993-6

    Article  PubMed  Google Scholar 

  2. 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, Koeckerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Chowbey P (2015) Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc 29:289–321. https://doi.org/10.1007/s00464-014-3917-8

    Article  CAS  PubMed  Google Scholar 

  3. Saggar VR, Sarangi R (2005) Endoscopic totally extraperitoneal repair of incarcerated inguinal hernia. Hernia 9:120–124. https://doi.org/10.1007/s10029-004-0290-x

    Article  CAS  PubMed  Google Scholar 

  4. Köckerling F (2019) TEP for elective primary unilateral inguinal hernia repair in men: what do we know? Hernia 23:439–459

    Article  Google Scholar 

  5. Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling 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, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 32:2773–2843

    Article  Google Scholar 

  6. Choi YY, Kim Z, Hur KY (2011) Transection of the hernia sac during laparoscopic totally extraperitoneal inguinal hernioplasty: is it safe and feasible? J Laparoendosc Adv Surg Tech 21:149–152. https://doi.org/10.1089/lap.2010.0237

    Article  Google Scholar 

  7. Sanford Z, Weltz AS, Singh D, Hanley R, Todd D, Belyansky I (2019) Minimally invasive multidisciplinary approach to chronic giant inguinoscrotal hernias. Surg Innov 26:427–431. https://doi.org/10.1177/1553350619828888

    Article  PubMed  Google Scholar 

  8. Daes J (2019) Enhanced view-totally extraperitoneal approach (eTEP) access in hernia repair. Cir Esp 98(5):249–250

    Article  Google Scholar 

  9. Ng SC, Lau SYC, Wardill D (2019) How to do an extended totally extraperitoneal mesh repair for groin hernias. ANZ J Surg 89:1324–1325. https://doi.org/10.1111/ans.15456

    Article  PubMed  Google Scholar 

  10. Zendejas B, Onkendi EO, Brahmbhatt RD, Greenlee SM, Lohse CM, Farley DR (2011) Contralateral metachronous inguinal hernias in adults: role for prophylaxis during the TEP repair. Hernia 15:403–408. https://doi.org/10.1007/s10029-011-0784-2

    Article  CAS  PubMed  Google Scholar 

  11. Uchida H, Matsumoto T, Ijichi H, Endo Y, Koga T, Takeuchi H, Kusumoto T, Muto Y, Kitano S (2010) Contralateral occurrence after laparoscopic total extraperitoneal hernia repair for unilateral inguinal hernia. Hernia 14:481–484. https://doi.org/10.1007/s10029-010-0690-z

    Article  CAS  PubMed  Google Scholar 

  12. Lee CH, Chiu YT, Cheng CF, Wu JC, Yin WY, Chen JH (2017) Risk factors for contralateral inguinal hernia repair after unilateral inguinal hernia repair in male adult patients: analysis from a nationwide population based cohort study. BMC Surg 17:106. https://doi.org/10.1186/s12893-017-0302-2

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, Belle Vue Clinic, Loudon Street, Kolkata, India

    Sarfaraz J. Baig & Pallawi Priya

  2. Department of General and Laparoscopic Surgery, Sir Ganga Ram Hospital, New Delhi, India

    Anmol Ahuja

Authors
  1. Sarfaraz J. Baig
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  2. Pallawi Priya
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  3. Anmol Ahuja
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Contributions

SJB conceptualized the paper; SJB, PP, and AA wrote the article. PP did graphics and images for the article. All three authors have read and approved the final manuscript.

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Correspondence to Pallawi Priya.

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Sarfaraz J Baig, Pallawi Priya, and Anmol Ahuja have no conflicts of interest or financial ties to disclose.

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Baig, S.J., Priya, P. & Ahuja, A. Modified port positions for totally extraperitoneal (TEP) repair for groin hernias: our experience. Surg Endosc 35, 2154–2158 (2021). https://doi.org/10.1007/s00464-020-07620-6

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  • DOI: https://doi.org/10.1007/s00464-020-07620-6

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