Skip to main content
Log in

Laparoscopic trans-abdominal pre-peritoneal (TAPP) surgery for incarcerated inguinal hernia repair

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

This series was aimed to analyze feasibility, safety and postoperative quality of life of trans-abdominal pre-peritoneal repair in incarcerated hernia; the rationale was a safe hernia reduction, more accurate abdomen exploration, diagnosis and treatment of contralateral unknown hernia.

Methods

With a minimum follow-up of 30 months, 20 urgent incarcerated inguinal hernia patients were submitted to TAPP. Signs of strangulation, peritonitis and major comorbidity were exclusion criteria. Feasibility and safety were evaluated by ability to hernia reduction, conversion rate, operative time, perioperative mortality, morbidity, hospital stay, prosthesis infection and recurrence. Finally, quality of life was assessed by acute and chronic pain score, recovery of normal activities, return to work and patients’ satisfaction survey.

Results

Under vision sac reduction was always achieved, incision of internal ring during the reduction manoeuvre was necessary in 40% of pts, intraoperative complications, conversions or perioperative mortality were not observed. In one case (5%) partial omentectomy was necessary. Contralateral hernia was diagnosed and repaired in 20%. Median operative time was 81.3 min, postoperative minor complications were recorded in 5 patients (25%), median in hospital stay was 2 days. After a median follow-up of 39 months, 1 patient recurred (5%). Acute pain, was scored 3 as median value (range 1–5), only one patient scored 2 as chronic pain during follow-up.

Conclusions

Laparoscopic approach for incarcerated inguinal hernia repair is not the standard treatment. In our experience, with the limit of a single-surgeon series, selected patients showed satisfactory results in terms of feasibility, safety, postoperative quality of life and patients’ satisfaction were observed. Few series about this topic were published. More prospective trials are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barkun JS, Wexler MJ, Hinchey EJ, Thibeault D, Meakins JL (1995) Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomized controlled trial. Surgery 118:703–710

    Article  CAS  PubMed  Google Scholar 

  2. Vogt DM, Curet MJ, Pitcher DE, Martin DT, Zucker KA (1995) Preliminary results of a prospective randomized trial of laparoscopic versus conventional inguinal herniorhaphy. Am J Surg 169:84–90

    Article  CAS  PubMed  Google Scholar 

  3. Fitzgibbons RJ Jr, Camps J, Cornet DA, Nguyen NX, Litke BS, Annibali R, Salerno GM (1995) Laparoscopic inguinal herniorhaphy. Results of a multicenter trial. Ann Surg 221(1):3–13

    Article  PubMed  PubMed Central  Google Scholar 

  4. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90(12):1479–1492

    Article  CAS  PubMed  Google Scholar 

  5. Hernia Trialists Collaboration EU (2002) Laparoscopic versus open groin hernia repair: meta-analysis of randomized trials based on individual patient data. Hernia 6(1):2–10

    Article  Google Scholar 

  6. Mahon D, Decadt B, Rhodes M (2003) Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. SurgEndosc 17:1386–1390

    CAS  Google Scholar 

  7. McCormack K, Scott NW, Go PM, Ross S, Grant AM, EU Hernia Trialists Collaboration (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001785

    Article  PubMed  PubMed Central  Google Scholar 

  8. Neumayer L, Giobbie-Hurder A, Jonasson O, Fitgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827

    Article  CAS  PubMed  Google Scholar 

  9. Simons MP, Aufena T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the Treatment of inguinal hernia in adult patients. Hernia 13(4):343–403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Ishihara T, Kubota K, Eda N, Ishibashi S, Harguchi Y (1996) Laparoscopic approach to incarcerated inguinal hernia. SrgEndosc 10:1111–1113

    CAS  Google Scholar 

  11. Leibl BJ, Schnedt CG, Kraft K, Kraft B, Bittner R (2001) Laparoscopic transperitoneal hernia repair of incarcerated hernias: is it feasible? Results of a prospective study. Surg Endosc 15(10):1179–1183

    Article  CAS  PubMed  Google Scholar 

  12. Gallegos NC, Dawson J, Jarvis M, Hobsley M (1991) Risk of strangulation in groin hernias. Br J Surg 78:1171–1173

    Article  CAS  PubMed  Google Scholar 

  13. Santoro E, Agresta F, Aloisi P, Caravani A, Mancini R, Mulieri G, Ciardo LF, Bedin N, Mulieri M (2005) Is minilaparoscopic inguinal hernia repair feasible? A preliminary experience. J Laparoendosc Adv Surg Tech 15(3):294–297

    Article  Google Scholar 

  14. Picchio M, DeAngelis F, Zazza S, Di Filippo A, Mancini R, Pattaro G, Stipa F, OluseyeAdisa A, Marino G, Spaziani E (2012) Drain after elective laparoscopic cholecystectomy. A randomized multicentre controller trial.SurgEndosc26(10):2817–2822

  15. Ferzli G, Shapiro K, Chaudry G, Patel S (2004) Laparoscopic extraperitoneal approach to acutely incarcerated inguinal hernia. Surg Endosc 18:228–231

    Article  CAS  PubMed  Google Scholar 

  16. SaggarVr SR (2005) Endoscopic totally extraperitoneal repair of incarcerated inguinal hernia. Hernia 9:120–124

    Article  Google Scholar 

  17. Mainik F, Flade-Kuthe R, Kuthe A (2005) Total extraperitoneal endoscopic hernioplasty (TEP) in the treatment of incarcerated and irreponible inguinal and femoral hernias. Zemtralbl Chir 130:550–553

    Article  CAS  Google Scholar 

  18. Rebuffat C, Galli A, Scalambra MS, Balsamo F (2006) Laparoscopic repair of strangulated hernias. Surg Endosc 20:13113–13114

    Article  Google Scholar 

  19. Legnani GL, Rasini M, Pastori S, Sarli D (2008) Laparoscopic trans-peritoneal hernioplasty (TAPP) for the acute management of strangulated inguino-crural hernias: a report of nine cases. Hernia 12(2):185–188

    Article  CAS  PubMed  Google Scholar 

  20. Jagad RB, Shah J, Patel GR (2009) The laparoscopic trans peritoneal approach for irreducible inguinal hernias: Perioperative outcome in four patients. J Minim Access Surg 5(2):31–34

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hoffman A, Leshem E, Zmora O, Nachtomi O, Shabtai M, Ayalon A, Rosin D (2010) The combined laparoscopic approach for the treatment of incarcerated inguinal hernia. Surg Endosc 24:1815–1818

    Article  PubMed  Google Scholar 

  22. Choi YY, Kim Z, Hur YK (2011) Laparoscopic total extraperitoneal repair for incarcerated inguinal hernia. J Korean Surg Soc 80:426–430

    Article  PubMed  PubMed Central  Google Scholar 

  23. Siow SL, Mahendran HA, Hardin M, Chea CH, Azim NAN (2013) Laparoscopic transabdominal approach and its modified technique for incarcerated scrotal hernias. Asian J Surg 36:64–68

    Article  PubMed  Google Scholar 

  24. Shuo Y, Guangyong Z, Cujhong J, Jinxin C, Yilin Z, Yingmo S, Minggang W (2016) Transabdominal preperitoneal laparoscopic approach for incarcerated inguinal hernia repair. Medicine (Baltimore) 95(52):e5686

    Article  Google Scholar 

  25. HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22(1):1–165. https://doi.org/10.1007/s10029-017-1668-x. (Epub 2018 Jan 12)

    Article  Google Scholar 

  26. Watson SD, Saye W, Hollier PA (1993) Combined laparoscopic incarcerated herniorrhaphy and small bowel resection. Surg Laparosc Endosc 3:106–108

    CAS  PubMed  Google Scholar 

  27. Lavonius MI, Ovaka J (2000) Laparoscopy in the evaluation of the incarcerated mass in groin Hernia. Surg Laparosc Endosc 14:488–489

    CAS  Google Scholar 

  28. Lin E, Wear K, Tiszenkel HI (2002) Planned reduction of incarcerated groin hernias with hernia sac laparoscopy. Surg Endosc 16:936–938

    Article  CAS  PubMed  Google Scholar 

  29. Duluq JL, Wintriger P, Mahajna A (2009) Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc 23(3):482–486

    Article  Google Scholar 

  30. Fitzgibbons RJ, Giobbie-Hurder A, Gibbs JO, Dunlop D, Reda DJ, Mc Carthy M Jr (2006) Watchful Waiting versus repair of inguinal hernia in minimally symptomatic mens: a randomized clinical trial. JAMA 295(3):285–292

    Article  CAS  PubMed  Google Scholar 

  31. Mason RJ, Moazzez A, Sohn HJ, Berne TV, Katkhouda N (2011) Laparoscopic versus open anterior abdominal wall hernia repair:30-day morbidity and mortality using the ACS-NSQIP database. Ann Surg 254(4):641–652

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Mancini.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

Approval from the institution review board was not required for this study.

Human and animal rights

This article does not contain any studies with animal performed by any of the authors.

Informed consent

All human patients gave us a written informed consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mancini, R., Pattaro, G. & Spaziani, E. Laparoscopic trans-abdominal pre-peritoneal (TAPP) surgery for incarcerated inguinal hernia repair. Hernia 23, 261–266 (2019). https://doi.org/10.1007/s10029-018-1828-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-018-1828-7

Keywords

Navigation