Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 21;14(7):e27117.
doi: 10.7759/cureus.27117. eCollection 2022 Jul.

Indications and Outcomes of a Hybrid Method Combining Laparoscopic and Anterior Approaches for Inguinal Hernia Repair

Nao Kakizawa  1 , Shingo Tsujinaka  2 , Yuki Mizusawa  1 , Sawako Tamaki  1 , Ryo Maemoto  1 , Erika Machida  1 , Yuta Muto  1 , Masaaki Saito  1 , Nobuyuki Toyama  1 , Toshiki Rikiyama  1
Affiliations

Indications and Outcomes of a Hybrid Method Combining Laparoscopic and Anterior Approaches for Inguinal Hernia Repair

Nao Kakizawa et al. Cureus. .

Abstract

Introduction Surgery for complex inguinal hernia (IH) (recurrent IH or IH after radical prostatectomy (RP)) may be difficult because of the presumed scar or adhesion in the retropubic space. A hybrid method combining the laparoscopic and anterior approaches (HLAA) in a bidirectional surgical technique may be an option in complex IH cases. Methods Patients at our institution who underwent IH repair for complex IH using HLAA from April 2018 to November 2019 were included. We retrospectively evaluated the patient characteristics, IH diagnosis, intraoperative variables, complications, and hernia recurrence during the follow-up period. Results Twenty patients were involved in this study. Seven patients underwent hLAA for recurrent IH, whereas the remaining 13 underwent hLAA for IH after RP. Five patients had bilateral IH, all of whom had IH after RP. The type of IH was lateral in 21 patients, medial in six patients, and lateral and medial in two patients. Hernia repair was performed using a patch alone in two patients and a plug and patch in 18 patients. Seroma or hematoma was observed in five patients, and one patient experienced chronic pain. No hernia recurrence was observed during the median follow-up period of 24 months. Conclusion hLAA could facilitate precise diagnosis and intraoperative confirmation of repair for recurrent IH and IH after RP. The intraoperative findings and the cause of recurrence can be easily shared among surgeons in hLAA. Further investigations are necessary to determine the long-term efficacy of hLAA in a larger cohort.

Keywords: complex inguinal hernia; hybrid method; inguinal hernia after prostatectomy; inguinal hernia repair; recurrent inguinal hernia.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A case of recurrent IH on the right side after TAPP, medial hernia.
The mesh (shown by arrows) that was inserted during previous surgery and shrinking showed through the peritoneum, and the hernia orifice (arrowheads) was 3cm in diameter. TAPP- transabdominal preperitoneal approach
Figure 2
Figure 2. A case of recurrent IH on the right side after TAPP, medial hernia.
The hernia sac (arrow) was inflated. TAPP- transabdominal preperitoneal approach
Figure 3
Figure 3. A case of recurrent IH on the right side after TAPP, medial hernia.
A repair mesh (arrowheads) was plugged into the hernia orifice. TAPP- transabdominal preperitoneal approach
Figure 4
Figure 4. A case of left-sided recurrent IH after bilayer repair, medial hernia.
The hernia orifice (arrowheads) was 1.5 cm in diameter and severe adhesion (arrows) was suggested.
Figure 5
Figure 5. A case of right-sided IH after robot-assisted RP, lateral hernia.
The hernia orifice (arrowheads) was 1 cm in diameter.
Figure 6
Figure 6. A case of right-sided IH after robot-assisted RP, lateral hernia.
The hernia orifice (arrowheads) was 2 cm in diameter.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Pokorny H, Klingler A, Schmid T, et al. Hernia. 2008;12:385–389. - PubMed
    1. Re-recurrence after operation for recurrent inguinal hernia. a nationwide 8-year follow-up study on the role of type of repair. Bisgaard T, Bay-Nielsen M, Kehlet H. Ann Surg. 2008;247:707–711. - PubMed
    1. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A. Hernia. 2015;19:355–366. - PubMed
    1. Causes of recurrence in laparoscopic inguinal hernia repair. Siddaiah-Subramanya M, Ashrafi D, Memon B, Memon MA. Hernia. 2018;22:975–986. - PubMed
    1. Prospective randomized trial of laparoscopic (transabdominal preperitoneal-TAPP) versus open (mesh) repair for bilateral and recurrent inguinal hernia: incidence of chronic groin pain and impact on quality of life: results of 10 year follow-up. Bignell M, Partridge G, Mahon D, Rhodes M. Hernia. 2012;16:635–640. - PubMed

LinkOut - more resources