Is Endoscopic Totally Extraperitoneal Hernioplasty Justified for the Repair of Groin Hernia in Female Patients?

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2005 Nov 26

PMID 16308798

Citations 5

Authors

H Lau

N G Patil

W K Yuen

Affiliations

Soon will be listed here.

Abstract

Background: Groin hernia is an uncommon surgical pathology in females. The efficacy of the endoscopic approach for the repair of female groin hernia has yet to be examined. The current study was undertaken to compare the clinical outcomes of female patients who underwent open and endoscopic totally extraperitoneal inguinal or femoral hernioplasty (TEP).

Methods: From July 1998 to June 2004, 108 female patients who underwent elective repair of groin hernia were recruited. The patients were divided into TEP (n = 30) and open groups (n = 78) based on the type of operation. Clinical data and outcome parameters were compared between the two groups.

Results: The mean ages and hernia types were comparable between the two groups. All TEPs were successfully performed. The mean operative times were 52 min for unilateral TEP and 51 min for open repair. The difference was not statistically significant. Comparisons of the length of hospital stay, postoperative morbidity, pain score, and time taken to resume normal activities showed no significant differences between the two groups. A single patient in the TEP group experienced recurrence of hernia.

Conclusions: The findings show equivalent postoperative outcomes after TEP and open repair of groin hernia in female patients. Because the wound scar after open repair is well concealed beneath the pubic hair and no superior clinical benefits are observed after TEP, open repair appears to be the technique of choice for the management of primary groin hernia in females. The TEP approach should be reserved for female patients with recurrent or multiple groin hernia.

Citing Articles

Consensus on international guidelines for management of groin hernias.

van Veenendaal N, Simons M, Hope W, Tumtavitikul S, Bonjer J Surg Endosc. 2020; 34(6):2359-2377.

PMID: 32253559 DOI: 10.1007/s00464-020-07516-5.

Groin Hernias in Women-A Review of the Literature.

Kockerling F, Koch A, Lorenz R Front Surg. 2019; 6:4.

PMID: 30805345 PMC: 6378890. DOI: 10.3389/fsurg.2019.00004.

Dealing with the round ligament of uterus in laparoscopic groin hernia repair: a nationwide survey among experienced surgeons.

Schmidt L, Andresen K, Oberg S, Rosenberg J Hernia. 2018; 22(5):849-855.

PMID: 30069804 DOI: 10.1007/s10029-018-1802-4.

International guidelines for groin hernia management.

Hernia. 2018; 22(1):1-165.

PMID: 29330835 PMC: 5809582. DOI: 10.1007/s10029-017-1668-x.

Athletic Pubalgia in Females: Predictive Value of MRI in Outcomes of Endoscopic Surgery.

Matikainen M, Hermunen H, Paajanen H Orthop J Sports Med. 2017; 5(8):2325967117720171.

PMID: 28840145 PMC: 5546653. DOI: 10.1177/2325967117720171.

References

Nyhus L . Individualization of hernia repair: a new era. Surgery. 1993; 114(1):1-2. View

Munshi I, WANTZ G . Management of recurrent and perivascular femoral hernias by giant prosthetic reinforcement of the visceral sac. J Am Coll Surg. 1996; 182(5):417-22. View

Hernandez-Richter T, Schardey H, Rau H, Schildberg F, Meyer G . The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP). Surg Endosc. 2000; 14(8):736-40. DOI: 10.1007/s004640000108. View

Grant A, Scott N, ODwyer P . Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg. 2004; 91(12):1570-4. DOI: 10.1002/bjs.4799. View

Lau H, Patil N . Acute pain after endoscopic totally extraperitoneal (TEP) inguinal hernioplasty: multivariate analysis of predictive factors. Surg Endosc. 2003; 18(1):92-6. DOI: 10.1007/s00464-003-9068-y. View

Robinson M, Riley 3rd J, Brown F, Gremillion H . Sex differences in response to cutaneous anesthesia: a double blind randomized study. Pain. 1998; 77(2):143-149. DOI: 10.1016/S0304-3959(98)00088-8. View

Tok E, Ertunc D, Dilek U, Pata O, Erdogan O, Aydin S . The prevalence of stress urinary incontinence among women operated on for abdominal wall hernias. Acta Obstet Gynecol Scand. 2004; 83(10):962-4. DOI: 10.1111/j.0001-6349.2004.00521.x. View

Woodward A, Choe E, Flint L, Ferrara J . The incidence of secondary hernias diagnosed during laparoscopic total extraperitoneal inguinal herniorrhaphy. J Laparoendosc Adv Surg Tech A. 1998; 8(1):33-8. DOI: 10.1089/lap.1998.8.33. View

Rutkow I . Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am. 1999; 78(6):941-51, v-vi. DOI: 10.1016/S0039-6109(05)70363-7. View

10.

Colak T, Akca T, Kanik A, Aydin S . Randomized clinical trial comparing laparoscopic totally extraperitoneal approach with open mesh repair in inguinal hernia. Surg Laparosc Endosc Percutan Tech. 2003; 13(3):191-5. DOI: 10.1097/00129689-200306000-00010. View

11.

Mikkelsen T, Bay-Nielsen M, Kehlet H . Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg. 2002; 89(4):486-8. DOI: 10.1046/j.0007-1323.2002.02058.x. View

12.

Yalamarthi S, Kumar S, Stapleton E, Nixon S . Laparoscopic totally extraperitoneal mesh repair for femoral hernia. J Laparoendosc Adv Surg Tech A. 2005; 14(6):358-61. DOI: 10.1089/lap.2004.14.358. View

13.

Glassow F . An evaluation of the strength of the posterior wall of the inguinal canal in women. Br J Surg. 1973; 60(5):342-4. DOI: 10.1002/bjs.1800600503. View

14.

Andersson B, Hallen M, Leveau P, Bergenfelz A, Westerdahl J . Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial. Surgery. 2003; 133(5):464-72. DOI: 10.1067/msy.2003.98. View

15.

Lau H . Preperitoneal collection after endoscopic extraperitoneal inguinal hernioplasty in a patient with malignant ascites. JSLS. 2003; 7(2):173-5. PMC: 3015477. View