Paterson HM, Casey JJ, Nixon SJ. Totally extraperitoneal laparoscopic hernia repair in patients with previous lower abdominal surgery.
Hernia 2005;
9:228-30. [PMID:
15976931 DOI:
10.1007/s10029-005-0323-0]
[Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2004] [Accepted: 02/02/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION
Patients with lower abdominal scars are generally excluded from laparoscopic hernia repair due to the perceived technical difficulty and risk of visceral injury. This study examines the outcome of a series of patients who underwent totally extraperitoneal (TEP) inguinal hernia repair despite previous lower abdominal surgery.
METHODS
Retrospective review of 47 consecutive patients who underwent TEP inguinal hernia repair in the presence of lower abdominal scars between 1993 and 2002.
RESULTS
Thirty-five unilateral and 12 bilateral TEP hernia repairs were performed in the presence of 20 appendicectomy, 10 lower midline, 18 suprapubic and 5 paramedian incisions. Two cases were converted to open repair. There were no major complications and no early or late recurrences. Median operating time was 67.5 min and 83% of patients were managed as day cases.
CONCLUSIONS
Totally extraperitoneal laparoscopic hernia repair can be carried out safely in the presence of scars from previous lower abdominal surgery.
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