What is the ideal repair technique for triple hernia accompanied by umbilical and bilateral inguinal hernias?

Year 2022, , 163 - 167, 30.09.2022

Ahmet Türkan Ahmet Erdoğan

https://doi.org/10.47482/acmr.1109271

Abstract

Background: For patients with bilateral inguinal hernia (BIH) accompanied by an umbilical hernia (UH), there may be hesitations regarding the repair of all three hernias in the same session in terms of pain and possible problems in the healing process. Studies on these patients are rather rare in the literature. In the present study, the results of laparoscopic and open surgical treatment in patients with triple hernia accompanied by BIH and UH were compared.

Methods: The data of patients were analyzed retrospectively. Patients whose hernias were fully repaired with open surgery made up group 1, and patients who underwent laparoscopic transabdominal preperitoneal (TAPP) repair together with open UH repair made up group 2. There were 10 patients in group 1 and 11 patients in group 2. The patients’ umbilical defect diameter, whether inguinal hernia (IH) was scrotal or not, applied surgical technique, length of hospital stay, duration of the operation, postoperative complications, and recurrence status were evaluated. Results: While 19 (90.5%) of the patients were male, 2 (9.5%) were female. In group 2, recurrence of unilateral IH was seen in 1 (4.5%) patient. Complications developed in 3 (14.3%) patients: seroma in 1 patient in group 1; and seroma in 1 patient; and wound infection in another patient in group 2. There was no significant difference between the groups in terms of duration of the operation, length of hospital stay, or postoperative complications (p value, p=0.251, p=0.756, p=0.538, respectively)

Conclusion: In patients with triple hernia where umbilical and BIH occur together, open UH repair and IH repair can be performed safely by TAPP repair.

Keywords

Triple Hernia, Umbilical Hernia, Bilateral Inguinal Hernia, Transabdominal Preperitoneal Repair.

References

• 1. Korkmaz NB, Öğünç G, Mesci A. The isokinetic and isometric analysis of laparoscopic and conventional inguinal hernia repair effects on physical activity. Turk J Surg. 2011; 27(1):20-24.
• 2. Perez AJ, Strassle PD, Sadava EE, Gaber C, Schlottmann F. Nationwide analysis of inpatient laparoscopic versus open inguinal hernia repair. J Laparoendosc Adv Surg Tech. 2020; 30(3):292–98.
• 3. Poelman MM, van den Heuvel B, Deelder JD, Abis GSA, Beudeker N, Bittner RR, et al. EAES Consensus Development Conference on endoscopic repair of groin hernias. Surg Endosc. 2013;27(10):3505–19.
• 4. Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B, Gockel I. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair - A systematic review and metaanalysis of randomized controlled trials. BMC Surg. 2017;10;17(1):55.
• 5. Köckerling F, Simons MP. Current Concepts of Inguinal Hernia Repair. Visc Med. 2018;34(2):145-50.
• 6. Bertozzi M, Magrini E, Appignani A. Preliminary experience with laparoscopic repair of associated inguinal and umbilical hernias in children. Hernia. 2015;19(4):617-21.
• 7. Boiko VV, Parkhomenko KY, Gaft KL, Feskov OE. Simultaneous operations during umbilical and paraumbilikal herniarepair: possible or necessary? Wiad Lek. 2021;74(2):220-24.
• 8. Hamza Y, Gabr E, Hammadi H, Khalil R. Four-arm randomized trial comparing laparoscopic and open hernia repairs. Int J Surg. 2010;8(1):25–28.
• 9. Simons MP, Smietanski M, Bonjer HJ, Bittner R, Miserez M, Aufenacker TJ, et al. (The Hernia Surge Group). International guidelines for groin hernia management. Hernia. 2018;22:1–65.
• 10. Kamer E, Unalp HR, Derici H, Tansug T, Onal MA. Laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair: a retrospective study. J Postgrad Med. 2007;53(3):176-80.
• 11. Harriott CB, Dreifuss NH, Schlottmann F, Sadava EE. Incidence and risk factors for umbilical trocar site hernia after laparoscopic TAPP repair. A single high‑volume center experience. Surg Endosc. 2021;35(9):5167-72.