Scrotal hernias : a contraindication for an endoscopic procedure? Results of a single-institution experience in transabdominal preperitoneal repair

• Published in: Surgical endoscopy Vol. 14; no. 3; pp. 289 - 292
• Main Authors: LEIBL, B. J, SCHMEDT, C.-G, KRAFT, K, ULRICH, M, BITTNER, R
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01-03-2000; Springer Nature B.V
• Subjects: Abdomen; Biological and medical sciences; Contraindications; Hernia, Inguinal - surgery; Humans; Laparoscopy - methods; Male; Medical sciences; Middle Aged; Peritoneum - surgery; Postoperative Complications; Prospective Studies; Recurrence; Scrotum; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Mesh; Treatment Outcome; Hernia; Human; Scrotum; Endoscopic surgery; Scrotal diseases; Indication; Abdominal disease; Endoscopy; Suturation; Technique; Male genital diseases
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004640000045

Endoscopic repair was introduced for use with inguinal hernia therapy more than 10 years ago. The technique as well as the indications for this method are debated, however. As a borderline inguinal hernia situation, the scrotal hernia in particular evokes vehement objections to an endoscopic procedure because of the anticipated problems and complications in dissecting the extended hernia sac. The efficiency of the laparoscopic transabdominal preperitoneal (TAPP) technique in the treatment of scrotal hernia therefore is discussed in this article.
Laparoscopic hernia repair (TAPP) has been performed in our department since 1993. Data are collected by a prospective documentation of operative and follow-up results. For evaluation, a comparison of scrotal and normal hernia repair was performed.
Between April 1993 and June 1998 the TAPP technique was used to treat 191 scrotal hernias, 42 (22%) of which were recurrent hernias. The median operating time for a normal inguinal hernia repair was 45 min, whereas scrotal hernias required a median of 65 min and irreducible scrotral hernias a median of 68.5 min. Major complications were observed in 1.6% of scrotal and 0.6% of normal inguinal hernia repairs. The most frequent scrotal hernia repair problem was the formation of a seroma, 10.5% of which had to be evacuated. During a follow-up period of 30 months, we found a total of two recurrences (1.05%).
In scrotal hernia repair, TAPP is not associated with higher complication rates and can be performed with efficiency comparable with that in normal inguinal hernia repair.