Surgical technique and outcomes of transabdominal preperitoneal inguinal hernia repair after radical prostatectomy: dissection between the transversalis fascia and superficial layers of preperitoneal fascia

Ohuchi, Masakazu; Fukunaga, Masaki; Nagakari, Kunihiko; Azuma, Daisuke; Kohama, Shintaro; Nomoto, Jun; Sakamoto, Kazuhiro

doi:10.1007/s10029-018-1800-6

Cited by 14 publications

(7 citation statements)

References 13 publications

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“…This is because the wide preperitoneal dissection took a substantial amount of time. Even compared with other studies, 20 , 21 the operative time of TAPPH + IPTR in our study was very short. TAPPH + IPTR is fast and results in few recurrences and complications.…”

Section: Discussioncontrasting

confidence: 75%

Efficacy of Laparoscopic Iliopubic Tract Repair Plus Transabdominal Preperitoneal Hernioplasty for Treating Inguinal Hernia After Robot-assisted Radical Prostatectomy

Lee¹

2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Robot-assisted radical prostatectomy (RARP) is a risk factor for inguinal hernia (IH). Furthermore, in patients who have undergone RARP, the fibrotic scar tissue in the RARP area limits preperitoneal dissection. This study aimed to evaluate the efficacy of performing laparoscopic iliopubic tract repair (IPTR) in addition to transabdominal preperitoneal hernioplasty (TAPPH) to treat IH after RARP.Patients and Methods: A total of 80 patients with an IH after RARP were treated with TAPPH from January 2013 to October 2020 and were included in this retrospective study. Patients who underwent conventional TAPPH were categorized as the TAPPH group (25 patients with 29 hernias), whereas those who underwent TAPPH with IPTR were categorized as the TAPPH + IPTR group (55 patients with 63 hernias). The IPTR comprised suture fixation of the transversus abdominis aponeurotic arch to the iliopubic tract.Results: All patients had indirect IH. The incidence of intraoperative complications was significantly higher in the TAPPH group than in the TAPPH + IPTR group [13.8% (4/29) vs 0.0% (0/ 63), P = 0.011]. The average operative time was also significantly shorter in the TAPPH + IPTR group than in the TAPPH group (P < 0.001). There were no differences between the two groups in the duration of hospitalization, recurrence rate, and pain severity. Conclusions:The addition of laparoscopic IPTR to TAPPH for treating IH after RARP is safe and is associated with a minimal risk of intraoperative complications and a short operative time.

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Section: Discussioncontrasting

confidence: 75%

Efficacy of Laparoscopic Iliopubic Tract Repair Plus Transabdominal Preperitoneal Hernioplasty for Treating Inguinal Hernia After Robot-assisted Radical Prostatectomy

Lee¹

2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…The Retzius space is a potential retropubic space situated between the bladder and the pubic bone. Its boundaries include the transversalis fascia anteriorly, the preperitoneal fascia (or super cial umbilical bladder fascia) posteriorly [4,6,14,15], and the inferior epigastric vessels laterally. The identi cation of the second plane is based on the presence of avascular connective tissue that resembles a white spider web, which is considered signi cant and often referred to as the "holy planes" [5].…”

Section: Discussionmentioning

confidence: 99%

“…Proper positioning of the mesh within the preperitoneal space is crucial for effective inguinal hernia repair. The mesh should be placed with half in the Retzius space, between the super cial preperitoneal fascia and the retropubic transversalis fascia, and half in the Bogros space, between the deep preperitoneal fascia and the peritoneum [15]. This placement ensures complete coverage of the hernia defect and minimizes the risk of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Streamlining the totally extraperitoneal approach for laparoscopic inguinal hernia repair: the 3-2-1 method

Zhou

2023

Preprint

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Background The total extraperitoneal (TEP) technique is known for its complexity compared to the transabdominal preperitoneal technique (TAPP). This study aimed to streamline the TEP procedure by introducing the 3-2-1 method, which involves creating three surgical planes, implementing two transitions, and establishing a spacious preperitoneal space. The objective was to comprehensively evaluate the safety, efficacy, and reliability of this approach. Methods A total of 358 patients with 380 inguinal hernias underwent TEP repair using the 3-2-1 method via the retromuscular approach. Patient characteristics, operative time, hospital stay, complications, and recurrence rates were assessed. Results Among the hernias, 190 were on the right side, 140 on the left side, and 50 were bilateral. The distribution of hernia types included indirect hernia (201), direct hernia (132), compound hernia (16), complex hernia (6), and femoral hernia (3). The average operative time was 58 minutes for unilateral hernias and 110 minutes for bilateral hernias. Postoperative complications occurred in 32 cases (8.9%), but no serious complications were observed. The average hospital stay was 7 days, and patients were followed up for an average of 49 months. There were no cases of chronic pain or recurrence. Conclusions The 3-2-1 method for laparoscopic TEP repair of inguinal hernias proves to be a simple, safe, effective, and reliable approach.

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“…However, radical prostatectomy (RP) can result in the development of postprostatectomy inguinal hernias (PIH), the estimated incidence rates of which were reported as 4.2%-15.9% following surgery [7,8]. A recent report showed that TAPP for PIH is potentially reliable without prolonging the duration of operation [9]. However, the appropriate approach and repair method of the surgical procedure for PIH remains controversial because of surgical di culty arising from preperitoneal adhesion.…”

Section: Introductionmentioning

confidence: 99%

The Experience of Robot-assisted Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Following Robot-assisted Laparoscopic Radical Prostatectomy: A Cohort Study

Funamizu

Mineta

Ozaki

et al. 2022

Preprint

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BackgroundThere are no reports of robot-assisted laparoscopic transabdominal preperitoneal inguinal hernia repair (R-TAPP) for the patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). AimTo evaluate the feasibility and safety of R-TAPP in patients who underwent RALP for postprostatectomy inguinal hernia (PIH).MethodsThis is a prospective, single-center retrospective cohort study. R-TAPP was conducted in 74 consecutive patients from September 2016 to March 2020. Except for women and patients who underwent previous abdominal surgery, 70 patients were classified into two groups based on the absence or presence of PIH (PIH group or non-PIH group). The data were retrospectively compared to those who had not undergone RALP.ResultsSeventy patients were reviewed. Among them, 22.9% had previously undergone RALP. We identified 22 lesions in 16 patients (unilateral in 10; bilateral in 6) in the PIH group, and 67 lesions in 54 patients (unilateral in 41; bilateral in 13) in the non-PIH group. The PIH group showed a longer median operation time compared to the non-PIH group. However, postoperative complications—including seroma formation, hematoma, and surgical site infections—were not significantly different between the groups. There were no recorded vascular, bladder, or spermatic cord injuries in either group. There was no conversion to laparoscopic or open surgery in either group. The estimated blood loss was small, and hospitalization duration was one day in all cases. Moreover, there were no hernia recurrences within the 90-day follow-up period in either group.ConclusionR-TAPP seem to be a feasible and safe approach for inguinal hernia repair, even in patients who underwent RALP for prostate cancer.

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Surgical technique and outcomes of transabdominal preperitoneal inguinal hernia repair after radical prostatectomy: dissection between the transversalis fascia and superficial layers of preperitoneal fascia

Abstract: In TAPP for patients following prostatectomy, surgery can be performed safely and reliably without prolonging the operative duration by selecting a skilled practitioner and standardizing the technique.

Cited by 14 publications

References 13 publications

Efficacy of Laparoscopic Iliopubic Tract Repair Plus Transabdominal Preperitoneal Hernioplasty for Treating Inguinal Hernia After Robot-assisted Radical Prostatectomy

Efficacy of Laparoscopic Iliopubic Tract Repair Plus Transabdominal Preperitoneal Hernioplasty for Treating Inguinal Hernia After Robot-assisted Radical Prostatectomy

Streamlining the totally extraperitoneal approach for laparoscopic inguinal hernia repair: the 3-2-1 method

The Experience of Robot-assisted Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Following Robot-assisted Laparoscopic Radical Prostatectomy: A Cohort Study

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