Rare but important gastrointestinal complications after laparoscopic inguinal hernia repair: a single-center experience

Abstract

Transabdominal preperitoneal patch plasty (TAPP) versus total extraperitoneal patch plasty (TEP) are surgical techniques commonly used to treat inguinal hernia. However, studies indicate that both procedures may lead to significant complications, particularly gastrointestinal complications, some of which can be life-threatening. We statistically analyzed the complications caused by adult inguinal hernia patients admitted from 2018 to 2022. We focused on gastrointestinal complications and conducted a case-by-case analysis on their causes and treatment processes. A total of 1034 patients were included in the final analysis, with 783 patients receiving TAPP treatment and 251 patients undergoing TEP. The overall complication rate for the TAPP group was slightly higher at 4.72% compared to 3.58% in the TEP group, but the difference was not statistically significant (p = 0.446). The incidence of both common and gastrointestinal complications is similar between the two groups, with no significant difference observed. Five patients (0.48%) suffered gastrointestinal complications, one with gastric perforation after TEP surgery, and four during TAPP surgery. All five cases of gastrointestinal complications were Grade III or higher according to the Clavien-Dindo classification, and all required reoperation. Gastrointestinal complications, though rare in LIHR, often require readmission and reoperation. Attempting non-operative management of such complications may lead to disastrous consequences. The majority of these complications are attributed to improper use of surgical instruments, necessitating vigilance on the part of the surgical team in preventing them.

Keywords: Complications; Inguinal hernia; LIHR; TAPP; TEP.