Purpose: Radical prostatectomy is one of the most common urological surgeries. Inguinal hernia is a well-known complication of radical prostatectomy. There are many controversies about selection of surgical techniques for repair of inguinal hernia. Traditionally laparoscopic approach contraindicated for patients with history of lower abdominal surgery, but recent studies showed that it could be safe and successful and even has some advantages over open repair. In this prospective study we evaluated outcomes of laparoscopic hernia repair in patients who previously underwent radical prostatectomy.
Materials and Methods: In this prospective study, 34 consecutive patients diagnosed with inguinal hernia after radical retropubic prostatectomy underwent laparoscopic transabdominal inguinal repair and followed up for outcomes and complications.
Results: The surgery duration was 167.44 ± 52.85 min (75-230 min). No intraoperative complications occurred. Patients were discharged within 20.79 ± 4.76 hours (12-34 hours). 69.8% of cases (30 patients) needed analgesic administration. No conversion to open surgery occurred. There were 9.3% (4 hernias) hernia recurrences. We followed patients for 9.9 ± 5.33 months (2-19 months).
Conclusion: It is concluded that TAPP for inguinal hernia repair after radical prostatectomy has good results and is effective. But according to rate of recurrence, its safeness is conflicting. We notice no major complication in our patients during the time of follow up. This may be due to safety of the operation in the proposed patients. However, for a definite decision regarding recurrence rate or post-operative complications for long-term measurement have to be waited for.
J. Hugosson, J. Stranne and S. V. Carlsson, “Radical Re- tropubic Prostatectomy: A Review of Outcomes and Side- Effects,” Acta Oncologica, Vol. 50, No. S1, 2011, pp. 92- 97.
E. Xylinas, A. Daché and M. Rouprêt, “Is Radical Pro- statectomy a Viable Therapeutic Option in Clinically Lo- cally Advanced (cT3) Prostate Cancer?” BJU Interna-tional, Vol. 106, No. 11, 2010, pp. 1596-1600
P. C. Walsh, “Anatomic Radical Prostatectomy: Evolu-tion of the Surgical Technique,” Journal of Urology, Vol. 160, No. 6, 1998, pp. 2418-2424.
M. Wirth, “Radical Prostatectomy—The Gold Standard in the Treatment of Localised and Locally Advanced Prostate Cancer,” European Journal of Cancer, Vol. 47, Suppl. 1, 2011, p. S49.
M. Han, A. W. Partin, C. R. Pound, et al., “Long-Term Biochemical Disease-Free and Cancer-Specific Survival Following Anatomic Radical Retropubic Prostatectomy: The 15-Year Johns Hopkins Experience,” Urologic Clin-ics of North America, Vol. 28, No. 3, 2001, pp. 555-565.
L. Chun and M. A. Abbas, “Rectourethral Fistula Fol-lowing Laparoscopic Radical Prostatectomy,” Techniques in Coloproctology, Vol. 15, No. 3, 2011, pp. 297-300.
J. Maarouf, J. Ghorbel, Z. Gammoudi, et al., “Anastomo-tic Stricture after Radical Prostatectomy (about 7 Cases),” Urology, Vol. 76, No. 3, 2010, p. S103.
L. Glickman, G. Godoy and H. Lepor, “Changes in Con-tinence and Erectile Function between 2 and 4 Years after Radical Prostatectomy,” Journal of Urology, Vol. 181, No. 2, 2009, pp. 731-735.
Twu CM, Ou YC, Yang CR, et al. Predicting risk factors for inguinal hernia after radical retropubic prostatectomy. Urology. 2005;66:814e818.
Sekita N, Suzuki H, Kamijima S, et al. Incidence of inguinal hernia after prostate surgery: open radical retropubic prostatectomy versus open simple prostatectomy versus transurethral resection of the prostate. Int J Urol. 2009;16: 110e113.
Finley DS, Rodriguez E Jr, Ahlering TE. Combined inguinal hernia repair with prosthetic mesh during transperitoneal robot assisted laparoscopic radical prostatectomy: a 4-year experience. J Urol. 2007;178:1296e1299. discussion 1299e1300.
Lee BC, Rodin DM, Shah KK, et al. Laparoscopic inguinal hernia repair during laparoscopic radical prostatectomy. BJU Int. 2007;99:637e639.
Finley DS, Savatta D, Rodriguez E, et al. Transperitoneal robotic-assisted laparoscopic radical prostatectomy and inguinal herniorrhaphy. J Robotic Surg. 2008;1:269e272.
Camps J, Nguyen N, Annabali R, Fitzgibbons RJ Jr (1995) Laparoscopic inguinal herniorrhaphy: transabdominal techniques. Int Surg 80(1):18–25
Sosa JL, Puente I, Markley M, Tranakas N (1994) A modified technique of laparoscopic herniorrhaphy: operative approach and early results. Int Surg 79(4):300–303
Wishart GC, Wright D, O’Dwyer PJ (1995) Use of a Foley catheter to dissect the preperitoneal space for extraperitoneal endoscopic hernia repair. J Laparoendosc Surg 5(1):27–29
Dulucq JL (1992) Treatment of inguinal hernia by insertion of a subperitoneal patch under pre-peritoneoscopy. Chirurgie 118(1–2):83–85
Arregui ME, Davis CJ, Yucel O, Nagan RF (1992) Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 2(1):53–58
McKernan JB, Laws HL (1993) Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endosc 7(1):26–28
Leibl BJ, Jager C, Kraft B, Kraft K, Schwarz J, Ulrich M, Bittner R (2005) Laparoscopic hernia repair—TAPP or/and TEP? Langenbecks Arch Surg/Deutsche Gesellschaft Chirurgie 390(2):77–82
Krahenbuhl L, Schafer M, Buchler MW (1997) Laparoscopic transperitoneal inguinal hernia operation (TAPP). Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen 68(10):977–985
Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Pass C, Singh K, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 25:2773–2843
Claus CM1, Coelho JC, Campos AC, Cury Filho AM, Loureiro MP, Dimbarre D, Bonin EA. Laparoscopic inguinal hernioplasty after radical prostatectomy: is it safe? Prospective clinical trial. Hernia. 2014 Apr;18(2):255-9. doi: 10.1007/s10029-013-1204-6. Epub 2013 Dec 20.
Dulucq JL1, Wintringer P, Mahajna A. Totally extraperitoneal (TEP) hernia repair after radical prostatectomy or previous lower abdominal surgery: is it safe? A prospective study. Surg Endosc. 2006 Mar;20(3):473-6. Epub 2006 Jan 18.
Sakon M1, Sekino Y2, Okada M2, Seki H2, Munakata Y2. Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy. Hernia. 2017 Oct;21(5):745-748. doi: 10.1007/s10029-017-1639-2. Epub 2017 Aug 10.
Wauschkuhn CA1, Schwarz J, Bittner R. Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases. Surg Endosc. 2009 May;23(5):973-7. doi: 10.1007/s00464-008-0291-4. Epub 2009 Jan 1.