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Incidentally found obturator hernias during totally extraperitoneal (TEP) inguinal hernia repair: a single-center experience

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Abstract

Purpose

This study aimed to determine the occurrence of incidental obturator hernia and clinical risk factors of their appearance in patients undergoing totally extraperitoneal (TEP) inguinal hernioplasty.

Methods

Data were collected retrospectively from patients who underwent TEP inguinal hernioplasty between June 2020 and December 2022.

Results

A total of 251 patients were included in the study. Obturator hernias were found in 21 patients (8.4%). At admission, no patient presented clinical signs of an obturator hernia. There was a significant predominance of women in the obturator hernia compared to the non-obturator hernia group (28.6% vs. 10.9%, respectively, p=0.018). There was no correlation between age (p=0.479) and BMI (p=0.771) and the occurrence of obturator hernia. Additional obturator hernia repair within the TEP inguinal hernioplasty procedure did not influence the overall length of the surgery (60.86 minutes) compared to the standard TEP inguinal hernioplasty (61.09 minutes, p=0.876).

Conclusions

The TEP inguinal hernioplasty allows the detection and repair of incidental obturator hernia. Through thorough inspection of the obturator canal, an asymptomatic obturator hernia can be detected and adequately treated within the same procedure, without the impact on the surgery duration, when performed by an experienced hernia surgeon.

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Availability of data and materials

The data generated during this study are available within the article. Datasets analyzed during the current study preparation are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

References

  1. Köckerling F, Bittner R, Kofler M et al (2019) Lichtenstein versus total extraperitoneal patch plasty versus transabdominal patch plasty technique for primary unilateral inguinal hernia repair: a registry-based, propensity score-matched comparison of 57,906 patients. Ann Surg 269:351. https://doi.org/10.1097/SLA.0000000000002541

    Article  PubMed  Google Scholar 

  2. Gavriilidis P, Davies RJ, Wheeler J et al (2019) Total extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty: a systematic review by updated traditional and cumulative meta-analysis of randomised-controlled trials. Hernia 23:1093–1103. https://doi.org/10.1007/s10029-019-02049-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Scheuermann U, Niebisch S, Lyros O et al (2017) Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair—a systematic review and meta-analysis of randomized controlled trials. BMC Surg 17:55. https://doi.org/10.1186/s12893-017-0253-7

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wei FX, Zhang YC, Han W et al (2015) Transabdominal Preperitoneal (TAPP) Versus Totally Extraperitoneal (TEP) for laparoscopic hernia repair: a meta-analysis. Surg Laparosc Endosc Percutan Tech 25:375–383. https://doi.org/10.1097/SLE.0000000000000123

    Article  PubMed  Google Scholar 

  5. Dulucq J-L, Wintringer P, Mahajna A (2011) Occult hernias detected by laparoscopic totally extra-peritoneal inguinal hernia repair: a prospective study. Hernia 15:399–402. https://doi.org/10.1007/s10029-011-0795-z

    Article  PubMed  Google Scholar 

  6. Chang S-S, Shan Y-S, Lin Y-J et al (2005) A review of obturator hernia and a proposed algorithm for its diagnosis and treatment. World J Surg 29:450–454. https://doi.org/10.1007/s00268-004-7664-1

    Article  PubMed  Google Scholar 

  7. Rodríguez-Hermosa JI, Codina-Cazador A, Maroto-Genover A et al (2008) Obturator hernia: clinical analysis of 16 cases and algorithm for its diagnosis and treatment. Hernia 12:289–297. https://doi.org/10.1007/s10029-007-0328-y

    Article  PubMed  Google Scholar 

  8. Old O, Kulkarni S, Hardy T et al (2015) Incidental non-inguinals hernias in totally extra-peritoneal hernia repair. Ann R Coll Surg Engl 97:120–124. https://doi.org/10.1308/003588414X14055925058959

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Susmallian S, Ponomarenko O, Barnea R, Paran H (2016) Obturator hernia as a frequent finding during laparoscopic pelvic exploration: a retrospective observational study. Medicine (Baltimore) 95:e4102. https://doi.org/10.1097/MD.0000000000004102

    Article  PubMed  Google Scholar 

  10. Li Z, Gu C, Wei M et al (2021) Diagnosis and treatment of obturator hernia: retrospective analysis of 86 clinical cases at a single institution. BMC Surg 21:124. https://doi.org/10.1186/s12893-021-01125-2

    Article  PubMed  PubMed Central  Google Scholar 

  11. Schizas D, Apostolou K, Hasemaki N et al (2021) Obturator hernias: a systematic review of the literature. Hernia 25:193–204. https://doi.org/10.1007/s10029-020-02282-8

    Article  CAS  PubMed  Google Scholar 

  12. Mercado M, Diab J, Loi K (2021) A delayed diagnosis of obturator hernia hoodwinked by previous laparoscopic inguinal hernia repair. J Surg Case Rep 2021:rjab407. https://doi.org/10.1093/jscr/rjab407

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nasir BS, Zendejas B, Ali SM et al (2012) Obturator hernia: the Mayo Clinic experience. Hernia 16:315–319. https://doi.org/10.1007/s10029-011-0895-9

    Article  CAS  PubMed  Google Scholar 

  14. Shapiro K, Patel S, Choy C et al (2004) Totally extraperitoneal repair of obturator hernia. Surg Endosc 18:954–956. https://doi.org/10.1007/s00464-003-8212-z

    Article  CAS  PubMed  Google Scholar 

  15. Siwiński D (2005) Neuropathy of the obturator nerve as a source of pain in soccer players. Chir Narzadow Ruchu Ortop Pol 70:201–204

    PubMed  Google Scholar 

  16. Bradshaw C, McCrory P, Bell S, Brukner P (1997) Obturator nerve entrapment: a cause of groin pain in athletes. Am J Sports Med 25:402–408. https://doi.org/10.1177/036354659702500322

    Article  CAS  PubMed  Google Scholar 

  17. Yale SH, Tekiner H, Yale ES (2021) Role of the signs of obturator hernia in clinical practice. Hernia 25:235–236. https://doi.org/10.1007/s10029-020-02296-2

    Article  CAS  PubMed  Google Scholar 

  18. Karasaki T, Nakagawa T, Tanaka N (2014) Obturator hernia: the relationship between anatomical classification and the Howship-Romberg sign. Hernia 18:413–416. https://doi.org/10.1007/s10029-013-1068-9

    Article  CAS  PubMed  Google Scholar 

  19. Salameh JR (2008) Primary and unusual abdominal wall hernias. Surg Clin North Am 88:45–60. https://doi.org/10.1016/j.suc.2007.10.004

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Minimally Invasive and Trauma Surgery, Francis Raszeja Municipal Hospital, Mickiewicza 2 Street, 60-834, Poznan, Poland

    Jacek Bialecki

  2. Department of General and Oncologic Surgery, St. Joseph Hospital, Mikolow, Poland

    Ryszard Antkowiak & Marcin Adamiecki

  3. Faculty of Mechanical Engineering, Institute of Biomedical Engineering, Bialystok University of Technology, Bialystok, Poland

    Anna Kasperczuk EngD

  4. Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland

    Lukasz Antkowiak

  5. Department of General Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland

    Mateusz Szmit & Pawel Domoslawski

Authors
  1. Jacek Bialecki
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  2. Ryszard Antkowiak
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  3. Marcin Adamiecki
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  4. Anna Kasperczuk EngD
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  5. Lukasz Antkowiak
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  6. Mateusz Szmit
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  7. Pawel Domoslawski
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Corresponding author

Correspondence to Jacek Bialecki.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Consent to participate

Informed consent was obtained from all subjects involved in the study.

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Not applicable.

Ethics approval

Ethical review and approval were waived for this study due to the retrospective character of the present study, which does not necessitate IRB approval.

Guidelines and regulations

All methods were carried out in accordance with relevant guidelines and regulations. The study was performed in accordance with Helsinki Declaration.

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Bialecki, J., Antkowiak, R., Adamiecki, M. et al. Incidentally found obturator hernias during totally extraperitoneal (TEP) inguinal hernia repair: a single-center experience. Hernia (2024). https://doi.org/10.1007/s10029-024-02991-4

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  • DOI: https://doi.org/10.1007/s10029-024-02991-4

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