Endoscopic totally extraperitoneal repair of incarcerated inguinal hernia

Abstract

With the help of modifications in operating technique, Endoscopic Totally Extraperitoneal repair is feasible and effective in patients with incarcerated inguinal hernias and encompasses the advantages of endoscopic procedures.

Clinical research of preperitoneal drainage after endoscopic totally extraperitoneal inguinal hernia repair

“…Ferzli GS et al [23] have used a combined technique to scrotal hernia. Although TEP application is still controversial [18,24,25], lots of researchers are attempting to verify the usage of TEP on complicated and severe hernias [4,16,17,26]. The disposal of hernia sac has attracted enough interests [27,28].…”

“…After mesh placement without fixation (d), a standard 12F drainage tube was placed (e) through the lower 5 mm port (f). Endoscopic TEP approach and view of drainage placement [16,17]. Besides the perishing pathological conditions and possible organ injuries, the extensive adhesiolysis, remnant of hernia sac and the need for mesh fixation with tacks that may be a cause for seroma should also be taken into consideration.…”

The combined laparoscopic approach for the treatment of incarcerated inguinal hernia

“…A few series published to date have described either the TAPP or TEP approach for the treatment of incarcerated inguinal hernia [5][6][7][8][9][10]. A combined approach was described by Lavonius [18], in which exploratory laparoscopy was used for reduction and evaluation of bowel viability, and an open anterior approach was used for repair.…”

“…Initially, the transabdominal preperitoneal (TAPP) approach was more commonly used for reduction and repair of the incarcerated hernia [5,6]. Recently, a number of series have used the total extraperitoneal (TEP) approach as an option [7][8][9][10]. Whereas the transabdominal approach may be superior with regard to reduction and evaluation of the sac content, the extraperitoneal approach has the potential benefit of easy and familiar repair.…”

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

“…It reviews seven articles on this topic, dating from 1989 to 2008, reporting on 328 cases treated with total extraperitoneal (TEP) or transabdominal preperitoneal (TAPP) repair. Of these seven articles, two are LE 2b prospective cohort studies and five are LE 4 small case series [271][272][273][274][275][276][277]. The overall results of the Deeba et al study were that average operative time was 61.3 min, average hospital stay was 3.8 days, mortality rate was 0.28 %, complication rate was 10.3 %, conversion rate was 1.8 %, intestinal laparoscopic or minilaparotomy resection rate was 5.1 %, and reoperation rate was 0.9 %.…”