Laparoscopic Examination and Transabdominal Preperitoneal (TAPP) Approach with Biologic Mesh for Strangulated Direct Inguinal Hernia: a Case Series

2021 ◽  
Author(s):  
Tianhao Xie ◽  
Litao Liu ◽  
Yan Fu ◽  
Qian Sun ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Case Series ◽  
Biologic Mesh ◽  
Direct Inguinal Hernia ◽  
Transabdominal Preperitoneal

scholarly journals P154 DOES A PENO-SCROTAL APPROACH FOR PENILE PROSTHESIS IMPLANTATION INCREASE THE INCIDENCE OF INGUINAL HERNIAS POSTOPERATIVELY?

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Shadi Al-Bahri ◽  
Hazem Taifour
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Case Series ◽  
Penile Prosthesis ◽  
Signs And Symptoms ◽  
General Surgeon ◽  
Direct Inguinal Hernia ◽  
Prosthesis Implantation ◽  
Radiologic Imaging ◽  
History Of

Abstract Aim The incidence of direct inguinal hernia and reservoir migration post-penile prosthesis implantation is extremely rare. We present a case series of patients presenting with direct inguinal hernia following three-piece penile prosthesis implantation. Material and Methods Three patients presented with direct inguinal hernia shortly following penile prosthesis implantation for treatment of refractory erectile dysfunction due to venous leak that was confirmed on ultrasound imaging. All patients underwent standard open Lichtenstein tension free repair. Results All patients underwent penile prosthesis Implantation through a peno-scrotal approach in which the reservoir was placed in the space of Retzius. The first patient had reservoir displacement one day post-operatively presenting as an inguinal bulge and discomfort, and repaired the same day. The other two patients presented with symptoms of inguinal swelling and pain at 40 days and 8 months respectively. None of our patients had signs and symptoms of intestinal obstruction. Identifiable risk factors included high BMI and a history of smoking, however dissection and placement of the reservoir may play a role in weakening the floor of the inguinal canal. Conclusions Despite the rare incidence of inguinal hernia post-penile prosthesis implantation, identification of patients with risk factors for inguinal hernia development should be done preoperatively. This may be evaluated through preoperative radiologic imaging with an abdominal wall ultrasound or clinical examination by a general surgeon.

scholarly journals Laparoscopic Examination and Transabdominal Preperitoneal (TAPP) Approach with Biologic Mesh for Strangulated Direct Inguinal Hernia Accompanied by Small Intestinal Perforation

2021 ◽  
Author(s):  
Tianhao Xie ◽  
Shujie Cheng ◽  
Yan Fu ◽  
Xinli Sun ◽  
Xiangxiang Ren ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
General Anesthesia ◽  
Intestinal Perforation ◽  
Abdominal Cavity ◽  
Biologic Mesh ◽  
Incarcerated Inguinal Hernia ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernias ◽  
Small Intestinal

Abstract Background A direct inguinal hernia is caused by a weakness or defect in the floor of the Hesselbach triangle. It is believed that direct hernias are less likely to strangulate than indirect hernias, because the neck of the direct hernia is wide enough to avoid strangulation. Approximately 8.6% of all incarcerated inguinal hernia contents can be returned to the abdominal cavity spontaneously after general anesthesia, and intestinal ischemia or necrosis was detected by laparoscopic examination in approximately 40.9% of cases. However, which surgical approach or mesh for an acutely incarcerated and strangulated groin hernia is still no consensus. We retrospectively enrolled 12 patients with incarcerated inguinal hernias accompanied by small intestinal perforation who underwent laparoscopic examination when the hernia content spontaneously returned into the abdominal cavity after induction of general anesthesia in our institution.Results 1 of the 12 patients had developed temporary seroma; the other 2 had early postoperative pain. No evidence of hernia recurrence, chronic pain, infection, scrotal swelling, paralyticileus, persistent seroma, mortality, or any other complications were found during the follow-up. At 1 year and most recent follow-up, all patients were satisfied with the treatment outcome.Conclusions It is a necessary to detect abdominal viscera when incarcerated inguinal hernia contents return to the abdominal cavity spontaneously after general anesthesia, and laparoscopic examination is an efficient method. Laparoscopic TAPP technique with biologic meshes is a feasible method to treat strangulated inguinal hernias accompanied by small intestinal perforation. To better understand whether TAPP or biologic mesh apply to strangulated inguinal hernia (especially enterectomy) and evaluate its wider application, this treatment will need to be tested in larger clinical trials.

Suture and Fixation of the Transversalis Fascia during Robotic-Assisted Transabdominal Preperitoneal Hernia Repair to Prevent Seroma Formation after Direct Inguinal Hernia Repair

2020 ◽  
pp. 155335062096097
Author(s):  
Ramon Pini ◽  
Francesco Mongelli ◽  
Francesco Proietti ◽  
Agnese Cianfarani ◽  
Fabio Garofalo ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Perforated Appendicitis ◽  
Seroma Formation ◽  
Lightweight Mesh ◽  
Transversalis Fascia ◽  
Direct Inguinal Hernia ◽  
Robotic Assisted ◽  
Conversion To Open Surgery ◽  
Transabdominal Preperitoneal

Background. Seroma formation after videoendoscopic repair of inguinal hernias, known as “pseudorecurrence”, may vary from an asymptomatic, self-limiting occurrence to a painful, chronic problem. The aim of this study was to investigate the incidence of postoperative seroma in robotic-assisted transabdominal preperitoneal hernia repair (R-TAPP), modified by suturing and fixating the transversalis fascia to the Cooper ligament. Methods. The study was approved by the local ethics committee (2019-01132 CE-3495). Patients undergoing R-TAPP for direct inguinal hernia from October 2017 to December 2019 were included. In all patients, a barbed running suture of the transversalis fascia was performed to close the cavity resulting from the direct hernia reduction and to fix it to the Cooper ligament, then a lightweight mesh was placed. Demographic and clinical data were collected and analysed. Results. Over the study period, 67 R-TAPP in 51 patients were identified. All patients were male, with a mean age of 63.1 ± 12.7  years. There was 1 case of conversion to open surgery due to adhesions of the caecum to the groin as a result of perforated appendicitis. The mean length of the hospital stay was 1.8 ± .6  days. After discharge, no cases of seroma or recurrence at 30  days nor chronic pain at a mean follow-up of 10.3 ± 6.8  months was detected. Conclusions. In the treatment of direct inguinal hernia with R-TAPP, suturing and anchoring the transversalis fascia to the Cooper ligament are safe, feasible and recommendable in order to prevent postoperative seromas.

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