Risk Factors for Peritoneal Tear in Laparoscopic Totally Extraperitoneal Inguinal Hernioplasty

Area of Science:

• Laparoscopic surgery
• Hernia repair
• Surgical complications

Background:

• Peritoneal tears (PTs) are a frequent intraoperative complication during laparoscopic total extraperitoneal hernia repair (TEP).
• PTs often lead to conversion to open surgery and lack established prevention strategies.
• Understanding the risk factors for PTs is crucial for improving TEP outcomes.

Purpose of the Study:

• To identify and evaluate the risk factors associated with the development of peritoneal tears during TEP procedures.
• To provide insights into preventing intraoperative complications in TEP surgery.

Main Methods:

• Retrospective analysis of 288 patients who underwent TEP between May 2019 and December 2023.
• Comparison of demographic characteristics, hernia details, surgical parameters, and complications between patients with and without PTs.
• Multivariate analysis to determine independent risk factors for PTs.

Main Results:

• The incidence of PTs was 22.2% (64 patients).
• Factors significantly associated with PTs included higher body mass index (BMI), previous surgery, scrotal hernia presence, and larger hernia defect size.
• Independent risk factors identified were previous lower abdominal surgery and scrotal hernia.

Conclusions:

• Peritoneal tears are a significant cause of conversion in TEP surgery.
• Previous lower abdominal surgery and scrotal hernia are the most critical independent risk factors for PT formation.
• This study highlights key factors to consider for preventing PTs in TEP.