Against Occam’s Razor: TAP Repair of Recurrent Inguinal Hernia with Concomitant Inversion of Original Polypropylene Plug
The patient is a 42 year old female who had undergone an open left inguinal hernia repair 13 years ago. She presents to clinic with a 1 year history of a recurrent left groin mass in the area of her previous repair. Interestingly, she states that at night when her bladder is full she feels a hard mass protruding from her left groin. In addition, she has pain in the area with straining or heavy lifting.
Because of her complaints of a mass protruding while her bladder was full, it was decided to perform a TAP repair so that the bladder could be filled and visualized during the operation. The patient had two concurrent issues noted intra-operatively: 1. Her full bladder was pushing the previously placed prolene plug, everting it through her repair and likely represented the mass which the patient was feeling. 2. In addition, there was a clear and separate recurrent left inguinal hernia just medial to the previous repair. There was no evidence of plug migration. We removed the plug, reduced her recurrent hernia and used a soft polyester mesh placed extra-peritoneally to cover both defects.
Session: Podium Video Presentation
Program Number: V042