No abstract

No abstract

We report the case of a 4-year-old girl treated by a laparoscopic transabdominal preperitoneal (TAPP) technique with polypropylene mesh in whom a primary contralateral hernia was found and repaired, closing the orifice with a suture. This 4-year-old female had a medical history of clubfoot treated by surgery during her first year of age, ureteral reimplantation because of stenosis, and laparoscopic cholecystectomy because of hydrocholecystis. She had recurrence 1 year after a conventional inguinal herniorraphy and was treated by the TAPP technique with polypropylene mesh. A primary contralateral hernia was found and repaired, and the orifice was closed with a suture. The child's acceptance of the procedure was good, and the postoperative evolution was uneventful, requiring minimal analgesia in the first 24 h. She was discharged the following day. Two years later, there have been no recurrences, and the girl is developing and carrying out activities in a normal way. The open technique remains the gold standard for hernioplasty in children, but laparoscopy may be an option, and it is possible that in some special cases, the use of mesh to reinforce the inguinal wall using the TAPP technique, although it is controversial, may be justified.

Spermatic cord entrapment is an unusual complication of inguinal herniorrhaphy. The case of a 52-year-old man who presented with severe pain along the left spermatic cord and testicle, varicocele, and dyspareunia after a laparoscopic bilateral inguinal hernia repair performed elsewhere is reported. Medical treatment failed, and laparoscopic exploration showed the vas deferens and spermatic vessels entrapped by a mesh slit that was pulling the genital branch of the genitofemoral nerve. The vas deferens and spermatic vessels were released, neurotomy of the affected nerve branch was performed, and a new mesh was positioned in the residual space. The patient's pain disappeared completely after the surgery and the varicocele decreased progressively. The patient remains asymptomatic at 1-year follow-up. Laparoscopy might be the approach of choice to treat some of the complications of laparoscopic hernia repair, not only because it allows better observation of the anatomic structures, but also because the surgical therapy can be done with minimal tissue damage compared to the traditional approach.

No abstract