Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in patients with previous lower abdominal surgery

Surgical Endoscopy
Toru ZuikiAlan Kawarai Lefor

Abstract

We have performed laparoscopic totally extraperitoneal (TEP) repair for inguinal hernia repair for the last 20 years. We use two balloon dilators (sphere and kidney type) to dissect the preperitoneal space for the TEP repair. It may be difficult to obtain exposure in patients who previously underwent lower abdominal surgery, because of adhesions to the abdominal wall. We reviewed our experience with inguinal hernia repairs to retrospectively analyze factors that limit the laparoscopic TEP approach. From 2006 to 2016, 313 patients (281 men and 32 women) underwent laparoscopic TEP inguinal hernia repair at Yuki Hospital. The medical records of these patients were reviewed, and data for patients who previously underwent lower abdominal surgery were analyzed. Eighty-four patients previously underwent lower abdominal surgery including appendectomy (N = 23), inguinal hernia repair [N = 45; including contralateral TEP repair (N = 26), ipsilateral anterior approach (N = 11)], and laparotomy with a lower abdominal midline incision (N = 22). TEP repair was successfully completed in 75 patients (75/84; 89%) and the procedure changed in nine patients to an anterior approach (N = 5), or transabdominal preperitoneal (TAPP) repair (N = 4). Th...Continue Reading

References

Apr 16, 1998·Surgical Endoscopy·E FelixB McKernan
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Jun 25, 2005·Hernia : the Journal of Hernias and Abdominal Wall Surgery·H M PatersonS J Nixon
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Jan 21, 2011·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Hiroki UchidaSeigo Kitano

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Citations

Jan 25, 2019·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Dimitrios PrassasAndreas Krieg
Dec 22, 2020·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Emre GundogduMehmet Mahir Ozmen

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