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Sliding inguinal hernias: scope of laparoscopic repair
Nirmal M Patle1, Om Tantia, Parmanand Prasad
1Department of Minimal Access and Bariatric Surgery, ILS Hospital, Kolkata, India.
Background:
Sliding hernias are an uncommon type of inguinal hernia. Very little is published in the literature regarding the outcome of laparoscopic repair of sliding hernia. The present series evaluates the feasibility and outcome of laparoscopic repair of these hernias.
Methods:
Retrospective analysis of prospectively maintained data of patients with sliding inguinal hernia undergoing laparoscopic repair from January 2003 to July 2010 was done. The patient demographics, clinical presentations, operative details, and complications were studied. Related literature was reviewed.
Results:
A total of 1136 patients underwent laparoscopic repair of inguinal hernia, of which 54 patients had sliding inguinal hernia (4.7%). Forty-one patients (76%) had left-sided hernia and 13 patients (24%) had right-sided hernias. Mean age of presentation was 63.5 years. Thirty-five patients (64.8%) presented as complicated hernias (27 irreducible, 7 obstructed, and 1 strangulated). Thirty-nine patients had sigmoid colon, 9 patients had cecum, 3 patients had ascending colon, and 3 patients had urinary bladder as the sliding component. Eight patients underwent Lichtenstein repair, 27 patients transabdominal preperitoneal repair, and 19 patients total extraperitoneal repair. Mean operating time of laparoscopic repair was 53 minutes (40-105 minutes). Five procedures (10.8%) were converted to open repair. Overall morbidity was 44.4%. Median hospital stay was 1.5 days (1-14 days). There were no recurrences in up to 7 years follow-up.
Conclusion:
Laparoscopic repair of sliding inguinal hernia is feasible and safe with good outcome. Laparoscopic transabdominal preperitoneal approach is the preferable method.
Insights
Laparoscopic repair of sliding inguinal hernias is feasible and safe, showing no recurrences in follow-up. The transabdominal preperitoneal approach is recommended for these uncommon hernias.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
Background:
- Sliding hernias are uncommon inguinal hernias.
- Limited literature exists on laparoscopic repair outcomes for sliding hernias.
Purpose of the Study:
- Evaluate the feasibility and outcomes of laparoscopic repair for sliding inguinal hernias.
Main Methods:
- Retrospective analysis of prospectively maintained data (January 2003 - July 2010).
- Studied patient demographics, clinical presentations, operative details, and complications.
- Reviewed related literature.
Main Results:
- 54 sliding hernias (4.7%) out of 1136 laparoscopic inguinal hernia repairs.
- Most common sliding components: sigmoid colon (39), cecum (9).
- No recurrences observed up to 7 years post-laparoscopic repair.
Conclusions:
- Laparoscopic repair of sliding inguinal hernias is feasible and safe.
- Transabdominal preperitoneal (TAPP) approach is the preferred laparoscopic method.
- Good outcomes with no recurrence support laparoscopic intervention.
