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Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy

BACKGROUND: Transabdominal prostatectomy results in scarring of the retropubic space and this might complicate subsequent preperitoneal dissection and mesh placement during minimally invasive inguinal hernia repair. Therefore, it suggested that an open anterior technique should be used rather than a...

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Autores principales: Dewulf, M., Aspeslagh, L., Nachtergaele, F., Pletinckx, P., Muysoms, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8847296/
https://www.ncbi.nlm.nih.gov/pubmed/33796906
http://dx.doi.org/10.1007/s00464-021-08497-9
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author Dewulf, M.
Aspeslagh, L.
Nachtergaele, F.
Pletinckx, P.
Muysoms, F.
author_facet Dewulf, M.
Aspeslagh, L.
Nachtergaele, F.
Pletinckx, P.
Muysoms, F.
author_sort Dewulf, M.
collection PubMed
description BACKGROUND: Transabdominal prostatectomy results in scarring of the retropubic space and this might complicate subsequent preperitoneal dissection and mesh placement during minimally invasive inguinal hernia repair. Therefore, it suggested that an open anterior technique should be used rather than a minimally invasive posterior technique in these patients. METHODS: In this single-center study, a retrospective analysis of a prospectively maintained database was performed. All patients undergoing inguinal hernia repair after previous transabdominal prostatectomy were included in this analysis, and the feasibility, safety, and short-term outcomes of open and robotic-assisted laparoscopic inguinal hernia repair were compared. RESULTS: From 907 inguinal hernia operations performed between March 2015 and March 2020, 45 patients met the inclusion criteria. As the number of patients treated with conventional laparoscopy was very low (n = 2), their data were excluded from statistical analysis. An open anterior repair with mesh (Lichtenstein) was performed in 21 patients and a robotic-assisted laparoscopic posterior transabdominal repair (rTAPP) in 22. Patient characteristics between groups were comparable. A transurethral urinary catheter was placed during surgery in 17 patients, most often in the laparoscopic cases (15/22, 68.2%). In the rTAPP group, a higher proportion of patients was treated for a bilateral inguinal hernia (50%, vs 19% in the Lichtenstein group). There were no intraoperative complications and no conversions from laparoscopy to open surgery. No statistically significant differences between both groups were observed in the outcome parameters. At 4 weeks follow-up, more patients who underwent rTAPP had an asymptomatic seroma (22.7% vs 5% in the Lichtenstein group) and two patients were treated postoperatively for a urinary tract infection (4.7%). CONCLUSION: A robotic-assisted laparoscopic approach to inguinal hernia after previous transabdominal prostatectomy seems safe and feasible and might offer specific advantages in the treatment of bilateral inguinal hernia repairs.
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spelling pubmed-88472962022-02-23 Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy Dewulf, M. Aspeslagh, L. Nachtergaele, F. Pletinckx, P. Muysoms, F. Surg Endosc Article BACKGROUND: Transabdominal prostatectomy results in scarring of the retropubic space and this might complicate subsequent preperitoneal dissection and mesh placement during minimally invasive inguinal hernia repair. Therefore, it suggested that an open anterior technique should be used rather than a minimally invasive posterior technique in these patients. METHODS: In this single-center study, a retrospective analysis of a prospectively maintained database was performed. All patients undergoing inguinal hernia repair after previous transabdominal prostatectomy were included in this analysis, and the feasibility, safety, and short-term outcomes of open and robotic-assisted laparoscopic inguinal hernia repair were compared. RESULTS: From 907 inguinal hernia operations performed between March 2015 and March 2020, 45 patients met the inclusion criteria. As the number of patients treated with conventional laparoscopy was very low (n = 2), their data were excluded from statistical analysis. An open anterior repair with mesh (Lichtenstein) was performed in 21 patients and a robotic-assisted laparoscopic posterior transabdominal repair (rTAPP) in 22. Patient characteristics between groups were comparable. A transurethral urinary catheter was placed during surgery in 17 patients, most often in the laparoscopic cases (15/22, 68.2%). In the rTAPP group, a higher proportion of patients was treated for a bilateral inguinal hernia (50%, vs 19% in the Lichtenstein group). There were no intraoperative complications and no conversions from laparoscopy to open surgery. No statistically significant differences between both groups were observed in the outcome parameters. At 4 weeks follow-up, more patients who underwent rTAPP had an asymptomatic seroma (22.7% vs 5% in the Lichtenstein group) and two patients were treated postoperatively for a urinary tract infection (4.7%). CONCLUSION: A robotic-assisted laparoscopic approach to inguinal hernia after previous transabdominal prostatectomy seems safe and feasible and might offer specific advantages in the treatment of bilateral inguinal hernia repairs. Springer US 2021-04-01 2022 /pmc/articles/PMC8847296/ /pubmed/33796906 http://dx.doi.org/10.1007/s00464-021-08497-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Dewulf, M.
Aspeslagh, L.
Nachtergaele, F.
Pletinckx, P.
Muysoms, F.
Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
title Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
title_full Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
title_fullStr Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
title_full_unstemmed Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
title_short Robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
title_sort robotic-assisted laparoscopic inguinal hernia repair after previous transabdominal prostatectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8847296/
https://www.ncbi.nlm.nih.gov/pubmed/33796906
http://dx.doi.org/10.1007/s00464-021-08497-9
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