Hrishikesh Salgaonkar, Raquel Maia, Lynette Loo, Wee Boon Tan, Sujith Wijerathne, Davide Lomanto. National University Hospital, Singapore
Laparoscopic repair of groin hernias is widely accepted approach over open due to lesser pain, faster recovery, better cosmesis and decreased morbidity. However, there is still debate on its use in large inguino-scrotal hernias, recurrent hernias and history of lower abdominal surgery anticipating adhesions and difficulty in dissecting extensive hernia sac. Retrospective analysis of prospectively collected data was done of patients undergoing laparoscopic repair of large inguino-scrotal, incarcerated groin hernia, recurrent cases after open or laparoscopic repair and history of previous lower abdominal surgery.
Between January 2013 to July 2015, 89 patients with large inguino-scrotal hernias, recurrent hernia, history of lower abdominal surgery, incarcerated femoral hernia underwent laparoscopic inguinal hernia repair. Patient characteristics, operating time, surgical technique, conversion rate, complications and recurrence up to 18 months recorded.
51 patients had large inguino-scrotal hernia, 22 recurrent hernia (17 previous open, 5 previous lap), 14 history of lower abdominal surgery (4 LSCS, 6 Appendectomy, 2 prostatectomy , 2 midline laparotomy), 1 incarcerated femoral hernia, 1 meshoma removal. 75 patients underwent total extraperitoneal (TEP) repair, 9 transabdominal pre-peritoneal (TAPP), 5 needed conversion to open. Mean operation time was 74 min for unilateral and 118 mins for bilateral hernia. Seroma formation seen in 19 patients, 2 minor wound infections treated conservatively.
We conclude that the laparoscopic approach can be safely employed for the treatment of complex groin hernias; surgical experience in laparoscopic hernia repair is mandatory with tailored technique in order to minimize morbidity and achieve good clinical outcomes with acceptable recurrence rates.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86292
Program Number: P024
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster