Transabdominal preperitoneal versus hybrid procedures for treating irreducible inguinal hernias: A retrospective controlled study

Hongming Zhang; Zhen Cao; Jinxin Cao; Jie Chen; Yuchen Liu; Minggang Wang

doi:10.1016/j.asjsur.2022.12.040

Transabdominal preperitoneal versus hybrid procedures for treating irreducible inguinal hernias: A retrospective controlled study

Asian J Surg. 2023 Oct;46(10):4222-4228. doi: 10.1016/j.asjsur.2022.12.040. Epub 2023 Jan 13.

Authors

Hongming Zhang¹, Zhen Cao², Jinxin Cao³, Jie Chen³, Yuchen Liu⁴, Minggang Wang⁵

Affiliations

¹ Department of General Surgery, No.1 Hospital of Zhangjiakou, Hebei, Zhangjiakou, PR China.
² Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
³ Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, PR China.
⁴ Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, PR China. Electronic address: lionkingchen@foxmail.com.
⁵ Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, PR China. Electronic address: wmgonly@126.com.

PMID: 36642546
DOI: 10.1016/j.asjsur.2022.12.040

Abstract

Background: Inguinal hernia is a common condition; however, irreducible inguinal hernias are rare. In this retrospective study, two laparoscopic procedures for irreducible inguinal hernia were compared.

Materials and methods: The study cohort comprised 88 patients who had undergone laparoscopic repair of primary irreducible inguinal hernias between 1 June 2011 and 31 December 2019. The patients were retrospectively divided into Hybrid (Group H) and Standard Transabdominal Preperitoneal (TAPP) Groups (Group S). Patient characteristics, hernia details, and intraoperative and postoperative complications were compared between study groups.

Results: There were no significant differences between the two groups in baseline characteristics, including age, sex, body mass index, hernia type, operation time, hospital stay, cost, and duration of follow-up. No recurrence or surgical site infection occurred in either group. There were no significant differences between the two groups in incidence of spermatic vessel injury (0% vs. 2.04%, P = 0.370), vas deferens injury (0% vs. 6.12%, P = 0.116), epigastric vessels injury (0% vs. 4.08%, P = 0.202), scrotal hematoma (7.69% vs. 2.04%, P = 0.206), dysuria (5.13% vs. 8.16%, P = 0.575), fever (17.95% vs. 16.32%, P = 0.841), seroma (25.64% vs. 32.65%, P = 0.474), chronic pain (0% vs. 2.04%, P = 0.370), sensation of a foreign body (2.56% vs. 2.04%, P = 0.870), or pain on ejaculation (0% vs. 2.04%, P = 0.370). The incidence of acute pain was higher in Group H than in Group S (43.59% vs. 8.16%, P = 0.000).

Conclusion: The hybrid TAPP procedure is a safe and feasible means of treating irreducible inguinal hernias. Though it is associated with a higher incidence of postoperative acute pain than the standard TAPP procedure, it may have advantages in avoiding injuries to the vas deferens and spermatic vessels.

Keywords: Hybrid; Inguinal hernia; Irreducible; Transabdominal preperitoneal.

MeSH terms

Acute Pain* / complications
Acute Pain* / surgery
Hernia, Inguinal* / complications
Hernia, Inguinal* / surgery
Herniorrhaphy / methods
Humans
Laparoscopy* / methods
Male
Pain, Postoperative / epidemiology
Pain, Postoperative / etiology
Retrospective Studies
Surgical Mesh / adverse effects
Treatment Outcome