Emergency TREPP for Strangulated Inguinal Hernia Repair: A Consecutive Case Series

Area of Science:

• General Surgery
• Hernia Surgery
• Surgical Innovation

Background:

• Strangulated inguinal hernia (SIH) necessitates emergency surgery, with no definitive guideline on preferred techniques.
• Open anterior approaches, like the Lichtenstein technique, are common.
• The TransREctus sheath Pre-Peritoneal (TREPP) technique, an open posterior approach, shows promise in elective hernia repair.

Purpose of the Study:

• To assess the feasibility and safety of the TransREctus sheath Pre-Peritoneal (TREPP) technique in the emergency treatment of strangulated inguinal hernias (SIH).
• To evaluate the outcomes of emergency TREPP (e-TREPP) in a high-volume hernia center.

Main Methods:

• Retrospective analysis of consecutive patients undergoing emergency TREPP (e-TREPP) for SIH from 2006-2016.
• Inclusion of data from electronic patient files and long-term physical outcome investigations.
• Definition of e-TREPP as immediate TREPP performed in the operating room.

Main Results:

• Thirty-three patients underwent e-TREPP for SIH.
• Two recurrences were observed (13 days and 16 months post-op).
• Two patients required surgical treatment for wound infections; one had mesh removal. No chronic postoperative inguinal pain was reported.

Conclusions:

• Emergency TransREctus sheath Pre-Peritoneal (e-TREPP) appears feasible and safe for SIH treatment in experienced surgeons.
• Postoperative complication rates for e-TREPP are comparable to alternative surgical techniques.
• Further research may support e-TREPP as a viable option for emergency hernia repair.