Hayashi Nobuyasu, PhD. Kinan Hospital
Background: One of the main reasons for the long learning curve associated with totally extraperitoneal (TEP) laparoscopic hernia repair lays in operational procedures for the hernia sac dissection in a narrow and limited preperitoneal space.
Objective: In this study, we investigated the effectiveness of our technique for the hernia sac dissection by a preperitoneal fascia-oriented approach.
Methods: We designed a randomized study of a single surgeon experience; 76 TEP repairs in adult males with unilateral, primary, EHS Classification L-2 inguinal hernia were included, which 24 were performed by non incision of the preperitoneal fascia (NI) and 27 were by incision of the preperitoneal fascia (FI). Patient characteristics and operative data were noted at surgery. Postoperative outcomes were assessed in both groups.
Results: Peritoneal injury occurred in two cases (8%) in NE group. The sac dissection time in NE group, 15.4 min was statistically longer compared with the time in FE group, 11.8 min (p<0.05). NE group required longer overall operative time with no statistical difference. The assessment of differences in postoperative pain, length of hospitalization, days required for return to work after the operation in both groups was considered statistically insignificant. There were no perioperative complications, except for two patients who developed a seroma and a subcutaneous bleeding, respectively in each group, which recovered after conservative treatment.
Conclusions: To gain more expertise in TEP repair, the importance of strategical incision of the preperitoneal fascia on the hernia sac must be appreciated. The preperitoneal fascia-oriented technique might facilitate the indirect hernia sac dissection in TEP repair.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79909
Program Number: P053
Presentation Session: Poster (Non CME)
Presentation Type: Poster