Endo-laparoscopic Inguinal Hernia Repair in Female Patients: Benefits and Results

Sujith Wijerathne, Eva Lourdes, Wee Boon Tan, Davide Lomanto, Prof. Minimally Invasive Surgery Centre, Department of Surgery, National University Health System, Singapore

Introduction: Groin hernia are relatively uncommon in females. Laparoscopy is an attractive approach in female groin hernia repair as it offers reduced surgical trauma, faster recovery and it has the added advantage of intra-operative diagnosis and treatment of incidental synchronous hernia which are mostly femoral hernia.

Methods: We prospectively collected data from female patients with groin hernia. Demographic profile, hernia laterality, type of hernia, EHS-classification, operative-time, complications, recurrence and time for recovery were collected and analyzed.

Results: 38 female patients with a mean age of 37.2 years (range 22-81) underwent 47 (29 unilateral and 9 bilateral) groin hernia repairs performed using the laparoscopic approach. 36(94.7%) primary hernia and 2(5.3%) recurrent hernia after open repair were reported. Out of 47 hernia, 25(53.2%) had indirect hernia, 6(12.8%) had direct, 7(14.9%) had femoral and 9(19.1%) had mixed hernia. TEP approach was used in 33(86.8%) and TAPP approach was used in 5(13.2%) patients.  A standard 10x15cm Polypropylene mesh was used in 42(89.4%) hernia and fixation done with absorbable tackers. 5(10.6%) hernia were repaired using an anatomical mesh without any fixation. No intraoperative complications were reported, 1(2.6%) patient had post-operative seroma. Mean pain score was VAS: 2.3 at 24hrs and 1 at 48hrs. No recurrences reported at 24months follow-up.

Conclusion: TEP or TAPP approach can be identified as the preferred surgical modality for groin hernia repair in females due to low complication rate and recurrence and concurrently help in diagnoses of missed hernia.