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Aiolfi A, Bona D, Calì M, Manara M, Bonitta G, Cavalli M, Bruni PG, Carmignani L, Danelli P, Bonavina L, Köckerling F, Campanelli G. Is previous radical prostatectomy a contraindication to minimally invasive inguinal hernia repair? A contemporary meta-analysis. Hernia 2024:10.1007/s10029-024-03098-6. [PMID: 38990229 DOI: 10.1007/s10029-024-03098-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/25/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Traditionally, radical prostatectomy (RP) has been considered a contraindication to minimally invasive inguinal hernia repair. Purpose of this systematic review was to examine the current evidence and outcomes of minimally invasive inguinal hernia repair after RP. MATERIALS AND METHODS Web of Science, PubMed, and EMBASE data sets were consulted. Laparoscopic transabdominal preperitoneal repair (TAPP), robotic TAPP (r-TAPP), and totally extraperitoneal (TEP) repair were included. RESULTS Overall, 4655 patients (16 studies) undergoing TAPP, r-TAPP, and TEP inguinal hernia repair after RP were included. The age of the patients ranged from 35 to 85 years. Open (49.1%), laparoscopic (7.4%), and robotic (43.5%) RP were described. Primary unilateral hernia repair was detailed in 96.3% of patients while 2.8% of patients were operated for recurrence. The pooled prevalence of intraoperative complication was 0.7% (95% CI 0.2-3.4%). Bladder injury and epigastric vessels bleeding were reported. The pooled prevalence of conversion to open was 0.8% (95% CI 0.3-1.7%). The estimated pooled prevalence of seroma, hematoma, and surgical site infection was 3.2% (95% CI 1.9-5.9%), 1.7% (95% CI 0.9-3.1%), and 0.3% (95% CI = 0.1-0.9%), respectively. The median follow-up was 18 months (range 8-48). The pooled prevalence of hernia recurrence and chronic pain were 1.1% (95% CI 0.1-3.1%) and 1.9% (95% CI 0.9-4.1%), respectively. CONCLUSIONS Minimally invasive inguinal hernia repair seems feasible, safe, and effective for the treatment of inguinal hernia after RP. Prostatectomy should not be necessarily considered a contraindication to minimally invasive inguinal hernia repair.
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Affiliation(s)
- Alberto Aiolfi
- Division of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, University of Milan, Via C. Belgioioso, 173, Milan, Italy.
| | - Davide Bona
- Division of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, University of Milan, Via C. Belgioioso, 173, Milan, Italy
| | - Matteo Calì
- Division of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, University of Milan, Via C. Belgioioso, 173, Milan, Italy
| | - Michele Manara
- Division of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, University of Milan, Via C. Belgioioso, 173, Milan, Italy
| | - Gianluca Bonitta
- Division of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, University of Milan, Via C. Belgioioso, 173, Milan, Italy
| | - Marta Cavalli
- Division of General Surgery, Department of Surgery, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Insubria, Milan, Italy
| | - Piero Giovanni Bruni
- Division of General Surgery, Department of Surgery, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Insubria, Milan, Italy
| | - Luca Carmignani
- Division of Urology, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, University of Milan, Milan, Italy
| | - Piergiorgio Danelli
- Division of General Surgery, Department of Biomedical and Clinical Sciences, University of Milan, L. Sacco University Hospital, 20157, Milan, Italy
| | - Luigi Bonavina
- Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, University of Milan, IRCCS Policlinico San Donato, Milan, Italy
| | - Ferdinand Köckerling
- Hernia Center, Vivantes Humboldt Hospital, Academic Teaching Hospital of Charité University Medicine, Am Nordgraben 2, 13509, Berlin, Germany
| | - Giampiero Campanelli
- Division of General Surgery, Department of Surgery, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Insubria, Milan, Italy
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Jung S, Lee JH, Lee HS. Early outcomes of robotic transabdominal preperitoneal inguinal hernia repair: a retrospective single-institution study in Korea. JOURNAL OF MINIMALLY INVASIVE SURGERY 2023; 26:128-133. [PMID: 37712312 PMCID: PMC10505366 DOI: 10.7602/jmis.2023.26.3.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
Purpose Robotic hernia repair has increased in popularity since the introduction of da Vinci robots (Intuitive Surgical). However, we lack quantitative analyses of its potential benefits. Herein, we report our initial experience with robotic transabdominal preperitoneal (R-TAPP) inguinal hernia repair. Methods We retrospectively reviewed the data from patients who underwent R-TAPP inguinal hernia repair with a prosthetic mesh using the da Vinci platform. Data on patient characteristics and surgical outcomes were also collected. Results Twenty-one patients (including 20 male patients [95.2%]) with a mean age of 54.1 ±16.4 years and body mass index of 23.8 ± 1.9 kg/m2 underwent R-TAPP inguinal hernia repair. Bilateral hernia repair was performed in two patients (9.5%), and six patients (28.5%) with scrotal hernia underwent R-TAPP hernia repair. A sigmoid colon sliding hernia was present in three patients (14.3%). The mean operation and console times were 91.8 ± 20.4 minutes and 154.5 ± 26.2 minutes, and 61.4 ± 16.9 minutes and 128.0 ± 25.5 minutes for unilateral and bilateral inguinal hernia, respectively. Spermatic vessel injury was identified intraoperatively in one patient. Two minor postoperative complications, postoperative ileus, and wound seroma were reported. The mean duration of hospitalization was 3.8 ± 0.9 days. No recurrence or conversion to open surgery was required. Conclusion Our findings suggest that R-TAPP inguinal hernia repair is safe and feasible. Its cost-effectiveness, optimal procedural steps, and indications for a robotic approach require further investigation.
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Affiliation(s)
- Sungwoo Jung
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jin Ho Lee
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyung Soon Lee
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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de Figueiredo SMP, Tastaldi L, Mao RMD, Phillips S, Lu R. Short-term outcomes of robotic inguinal hernia repair during robotic prostatectomy - An analysis of the Abdominal Core Health Quality Collaborative. Am J Surg 2023; 225:383-387. [PMID: 36115703 DOI: 10.1016/j.amjsurg.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/03/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Concomitant robotic-assisted laparoscopic prostatectomy (RALP) and robotic inguinal hernia repair (RIHR) has been reported. Nevertheless, data on its safety is lacking and some surgeons avoid performing both operations concurrently due to the potential risk of mesh related complications in the setting of a fresh vesicourethral anastomosis. We aimed to investigate differences in 30-day outcomes between patients undergoing RALP+RIHR and those undergoing RIHR alone. METHODS Patients who have undergone concomitant RALP and RIHR with 30-day follow-up available were identified within the Abdominal Core Health Quality Collaborative. Using a propensity score algorithm, they were matched with a cohort of patients undergoing RIHR alone based on confounders such as body mass index, age, ASA class, smoking, hernia size and recurrent status and prior pelvic operation. The groups were compared for 30-day rates of surgical site infection (SSI), surgical site occurrences (SSO), surgical site occurrences requiring operative intervention (SSOPI) and hernia recurrence. RESULTS 24 patients underwent RALP + RIHR and were matched to 72 patients who underwent RIHR alone (3:1). Median age was 64 years, 33% were obese and 17% smokers. No significant differences were found on 30-day rates of overall complications (21% RALP + RIHR vs. 15% RIHR, p = 0.53) and surgical site occurrences (12% RALP + RIHR vs.11% RIHR, p = 0.85). No patient in the RALP + RIHR group had a 30-day SSI, SSOPI or early recurrence. CONCLUSION RALP+RIHR appears not to result in increased rates of wound complications, overall complications or early recurrence when compared to patient undergoing RIHR alone. Prospective, controlled studies with larger number of patients are needed to confirm our findings.
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Affiliation(s)
- Sergio Mazzola Poli de Figueiredo
- Division of General Surgery, Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.
| | - Luciano Tastaldi
- Division of General Surgery, Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Rui-Min Diana Mao
- Division of General Surgery, Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Sharon Phillips
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Richard Lu
- Division of General Surgery, Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
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What lies beneath - No need to fear a minimally invasive approach to inguinal hernia repairs after prior low abdominal surgery. Am J Surg 2023; 225:250-251. [PMID: 36307335 DOI: 10.1016/j.amjsurg.2022.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022]
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Amundson JR, Attaar M, Forester B, Francis S, Kuchta K, Denham W, Linn J, Ujiki MB, Haggerty SP. Laparoscopic and robotic inguinal hernia repair are safe and effective after prior pelvic or low abdominal surgery. Am J Surg 2023; 225:252-257. [PMID: 36058753 DOI: 10.1016/j.amjsurg.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/02/2022] [Accepted: 08/19/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The ideal approach to inguinal hernia repair (IHR) after prior pelvic or low abdominal surgery is not agreed upon. We compared safety and outcomes of IHR between open, laparoscopic, and robotic approaches. METHODS This retrospective review of a prospective database analyzed demographic, perioperative, and quality of life data for patients who underwent IHR after pelvic or low abdominal surgery. RESULTS 286 qualifying patients underwent IHR between 2008 and 2020; 119 open, 147 laparoscopic, and 20 robotic. Laparoscopic repair led to faster cessation of narcotics and return to ADLs than open repair (all p <0.05). Post-operative complications, 30-day readmission, recurrences, and quality of life outcomes were equivalent, except less pain at 3-weeks post-op in the minimally invasive groups, p < 0.01. CONCLUSION Minimally invasive IHR after prior pelvic or low abdominal surgery is safe compared to an open approach. Laparoscopic repair provides faster recovery, yet patient satisfaction is equivalent regardless of surgical approach.
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Affiliation(s)
- Julia R Amundson
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States; Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, Chicago, IL, 60637, United States.
| | - Mikhail Attaar
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States; Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, Chicago, IL, 60637, United States
| | - Beau Forester
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
| | - Simone Francis
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
| | - Kristine Kuchta
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
| | - Woody Denham
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
| | - John Linn
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
| | - Michael B Ujiki
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
| | - Stephen P Haggerty
- Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, United States
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