Skip to main content
Log in

Laparoscopic TEP repair of inguinal hernia does not alter testicular perfusion

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

The effect of laparoscopic TEP repair on testicular perfusion is unclear. The procedure entails dissection of testicular blood vessels off the hernial sac and incorporation of a prosthetic mesh. This carries at minimum, a theoretical risk of compromise in testicular blood supply, which in turn may affect fertility. Our study aims to establish if any alteration in testicular perfusion occurs in very early (24 h), early (1 week) or late postoperative period (3 months) after laparoscopic TEP repair in the Indian population.

Methods

In our prospective trial, 20 patients underwent unilateral and 8 underwent bilateral laparoscopic TEP hernia repairs using standard technique by experienced surgeons. Flow parameters of testicular, capsular and intratesticular artery were noted using color Doppler ultrasound preoperatively and postoperatively and the postoperative resistive indexes of operated side (n = 36) were compared with preoperative values. Additionally, for unilateral repairs, flow parameters on operated side were compared with the non-operated side.

Results

No statistically significant difference was noticed in the resistive index of the arteries upon comparing these postoperative with preoperative values. For unilateral repairs, the flow parameters of the operated side were comparable with that of non-operated side (i.e. p > 0.05).

Conclusion

Laparoscopic TEP performed by experienced surgeons does not alter testicular flow dynamics in early or late postoperative period.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fong MD, Wantz GE (1992) Prevention of ischemic orchitis during inguinal hernioplasty. Surg Gynecol Obstet 174:399–402

    CAS  PubMed  Google Scholar 

  2. Klinge U, Klosterhalfen B, Muller M, Schumpelick V (1999) Foreign body reaction to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673

    Article  CAS  PubMed  Google Scholar 

  3. Middleton WD, Thorne D, Melson GL (1989) Colour Doppler ultrasound of the normal testis. Am J Roentgenol 152:293–297

    Article  CAS  Google Scholar 

  4. Beddy P, Ridgway PF, Geoghegan T, Peirce C, Govender P, Keane FBV, Torreggiani WC, Konlon KCP (2006) Inguinal hernia repair protects testicular function: a prospective study of open and laparoscopic herniorrhaphy. J Am Coll Surg 203:17–23

    Article  PubMed  Google Scholar 

  5. Ersin S, Aydin U, Makay O, Icoz G, Tamsel S, Sozbilen M, Killi R (2006) Is testicular perfusion influenced during laparoscopic inguinal hernia surgery? Surg Endosc 20:685–689

    Article  CAS  PubMed  Google Scholar 

  6. Koksal N, Altinli E, Sumer A, Celik A (2010) Impact of herniorrhaphy technique on testicular perfusion: results of a prospective study. Surg Laparosc Endosc Percutan Tech 20:186–189

    Article  PubMed  Google Scholar 

  7. Celik AS, Memmi N, Celebi F, Guzey D, Celik A, Kaplan R, Oncu M (2009) Impact of slit and nonslit mesh technique on testicular perfusion and volume in the early and late postoperative period of totally extraperitoneal preperitoneal technique in the patients with inguinal hernia. Am J Surg 198:287–291

    Article  PubMed  Google Scholar 

  8. Lal P, Philips P, Chander J, Ramteke VK (2010) Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair. Surg Endosc 24:1737–1745

    Article  Google Scholar 

  9. Zhu X, Cao H, Ma Y, Yuan A, Wu X, Miao Y, Guo S (2014) Totally extraperitoneal laparoscopic hernioplasty versus open extraperitoneal approach for inguinal hernia repair: a meta-analysis of outcomes of our current knowledge. Surgeon 12:94–105

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  11. El-Awady SE, Elkholy AA (2009) Beneficial effect of inguinal hernioplasty on testicular perfusion and sexual function. Hernia 13:251–258

    Article  CAS  PubMed  Google Scholar 

  12. Lima Neto EV, Goldenberg A, Jucá MJ (2007) Prospective study on the effects of a polypropylene prosthesis on testicular volume and arterial flow in patients undergoing surgical correction for inguinal hernia. Acta Cir Bras 22:266–271

    Article  PubMed  Google Scholar 

  13. Ramadan SU, Gokharman D, Tuncbilek I, Ozer H, Kosar P, Kacar M, Temel S, Kosar U (2009) Does the presence of mesh have an effect on the testicular blood flow after surgical repair of indirect inguinal hernia? J Clin Ultrasound 37:78–81

    Article  PubMed  Google Scholar 

  14. Dogra VS, Gottlieb RH, Oka M, Rubens D (2003) Sonography of the scrotum. Radiology 227:18–36

    Article  PubMed  Google Scholar 

  15. Aydede H, Erhan Y, Sakarya A, Kara E, Ilkgül O, Can M (2003) Effect of mesh and its localisation on testicular flow and spermatogenesis in patients with groin hernia. Acta Chir Belg 103:607–610

    Article  CAS  PubMed  Google Scholar 

  16. Stula I, Druzijanic N, Srsen D, Capkun V, Perko Z, Sapunar A, Kraljevic D, Bosnjak N, Pogorelic Z (2012) Influence of inguinal hernia mesh repair on testicular flow and sperm autoimmunity. Hernia 16:417–424

    Article  CAS  PubMed  Google Scholar 

  17. Uzzo RG, Lemack GE, Morrissey KP, Goldstein M (1999) The effects of mesh bioprosthesis on the spermatic cord structures: a preliminary report in a canine model. J Urol 161:1344–1349

    Article  CAS  PubMed  Google Scholar 

  18. Dilek ON, Yucel A, Akbulut G, Degirmenci B (2005) Are there adverse effects of herniorrhaphy techniques on testicular perfusion? Evaluation by color Doppler ultrasonography. Urol Int 75:167–169

    Article  PubMed  Google Scholar 

  19. Brisinda G, Cina A, Nigro C, Cadeddu F, Brandara F, Marniga G, Vanella S, Bonomo L, Civello IM (2008) Duplex ultrasound evaluation of testicular perfusion after tension-free inguinal hernia repair: results of a prospective study. Hepatogastroenterology 55:974–978

    PubMed  Google Scholar 

  20. Skawran S, Weyhe D, Schmitz B, Belyaev O, Bauer KH (2011) Bilateral endoscopic total extraperitoneal (TEP) inguinal hernia repair does not induce obstructive azoospermia: data of a retrospective and prospective trial. World J Surg 35:1643–1648

    Article  CAS  PubMed  Google Scholar 

  21. Peiper C, Junge K, Klinge U, Strehlau E, Krones C, Ottinger A, Schumpelick V (2005) The influence of inguinal mesh repair on the spermatic cord: a pilot study in the rabbit. J Invest Surg 18:273–278

    Article  PubMed  Google Scholar 

  22. Sucullu I, Filiz AI, Sen B, Ozdemir Y, Yucel E, Sinan H, Sen H, Dandin O, Kurt Y, Gulec B, Ozyurt M (2010) The effects of inguinal hernia repair on testicular function in young adults: a prospective randomized study. Hernia 14:165–169

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Bansal.

Ethics declarations

Conflict of interest

All authors declare no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (AVI 133126 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lal, P., Bansal, B., Sharma, R. et al. Laparoscopic TEP repair of inguinal hernia does not alter testicular perfusion. Hernia 20, 429–434 (2016). https://doi.org/10.1007/s10029-016-1479-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-016-1479-5

Keywords

Navigation