Combined laparoscopic and open extraperitoneal approach to scrotal hernias
Ferzli GS et al. – In cases where a large scrotal hernia may be difficult or dangerous to reduce laparoscopically, immediate conversion to an open repair may not be necessary. A combined laparoscopic and open approach can greatly assist in the visualization and dissection of the preperitoneal space, thereby facilitating reduction of the hernia and placement of the mesh.Methods
- Authors performed a retrospective review of 1890 TEP hernia repairs they performed from 1990 to 2010.
- Rate of conversion to an open approach or a combined laparoscopic and open approach was examined.
- Incidence of complications or recurrences was assessed over a 12–month follow–up period.
- Among the 1890 TEP repairs, 94 large scrotal hernias were identified.
- Of these, nine cases (9.5 %) required conversion to an open procedure due to an incarcerated and indurated omentum.
- Three were completed with a conventional open preperitoneal whereas six patients (6.4 %) underwent repair with the combined approach.
- In this group, no recurrences or complications were found over a 12–month period.