Laparoscopic repair of strangulated hernias

Surg Endosc. 2006 Jan;20(1):131-4. doi: 10.1007/s00464-005-0171-0. Epub 2005 Dec 7.

Abstract

Background: Although laparoscopic transabdominal preperitoneal polypropylene (TAPP) hernia repair is now a recognized procedure for groin hernia repair in patients undergoing elective surgery, there is a scarcity of data on TAPP repair in emergency situations such as those involving strangulated hernias.

Methods: Unless contraindicated, the authors' department considers laparoscopic TAPP repair the procedure of choice for all strangulated hernias. A prospective database of 1,532 consecutive hernia repairs performed between May 1998 and April 2004 was reviewed.

Results: A total of 28 irreducible strangulated hernias were observed and repaired through laparoscopic TAPP. There were three conversions (10.7%): one because of extensive adhesions and two because of bowel distention. Resection became necessary in 9 (36%) of the 25 cases involving effective TAPP repair of strangulated hernias. The mean operation time, with and without resection, was 103 and 55 min, respectively. The rate of postoperative morbidity was 4% because of one inguinal hematoma case. During a mean follow-up period of 340 days, there were no recurrences after TAPP repair.

Conclusions: For selected patients, the TAPP approach appears to be a good therapeutic option for strangulated hernias.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Female
  • Hernia, Inguinal / surgery*
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Laparoscopy* / standards
  • Male
  • Middle Aged
  • Polypropylenes
  • Retrospective Studies
  • Surgical Mesh
  • Time Factors
  • Treatment Outcome

Substances

  • Polypropylenes