Hernia repair during endoscopic extraperitoneal lymph node dissection

The objective of this study was to determine whether extraperitoneal lymph node dissection for the staging of prostate cancer and extraperitoneal herniorrhaphy could be performed concomitantly with acceptable operative time and morbidity. Sixty patients underwent endoscopic extraperitoneal lymph node dissection (EEPLND) between 1991 and 1996. Eleven of these had 14 hernias repaired with polypropylene mesh. Endoscopic hernia repair added an average of 15 to 20 minutes to the EEPLND, resulting in an average operative time of 127 minutes (range 90 to 182 minutes). There was no difference in postoperative pain between patients undergoing combined operations and those undergoing EEPLND alone. The mean hospital stay after either procedure was 48 hours. There were no complications in the group undergoing herniorrhaphy. We conclude that extraperitoneal endoscopic hernia repair can be safely performed with EEPLND when necessary.