Original Article

J Minim Invasive Surg 2009; 12(1): 50-53

Published online June 15, 2009

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

복막외 접근법에 의한 좌측 서혜부 탈장수술 시 반대편 탈장 검색의 의의

정춘식ㆍ이정은ㆍ조용걸ㆍ유상화ㆍ정규영ㆍ김승한ㆍ이동근

한솔병원 외과

The Incidence of the Occult Contralateral Hernia in Patients Undergoing Total Extraperitoneal (TEP) Repair of a Left Inguinal Hernia

Choon Sik Chung, M.D., Jeong Eun Lee, M.D., Yong Geul Joh, M.D., Sang Hwa Yu, M.D., Gyu Young Jeong, M.D., Seung Han Kim, M.D., Dong Keun Lee, M.D.

Department of Surgery, Hansol Hospital, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Laparoscopic herniorrhaphy (LH) can be used to examine the asymptomatic contralateral side and repair occult contralateral hernias coincidentally with reduced morbidity. In this prospective study, we evaluated the results of diagnostic exploration of the right side during total extraperitoneal (TEP) laparoscopic repair of left side inguinal hernias. Methods: A prospective study of 100 consecutive male patients undergoing TEP repair by a single surgeon (C.S) between January and June 2008 was conducted. Two cases that had transabdominal preperitoneal (TAPP) prosthetic repair and one intraperitoneal onlay mesh (IPOM) were excluded. We routinely explored the contralateral side to determine the incidence of right side occult hernia. Results: The mean age was 52 (range; 18∼82 years). Among the 100 patients, 17 had bilateral, 52 right and 31 left hernias on physical examination prior to surgery. Three of 31 diagnosed preoperatively as left inguinal hernia were confirmed to have occult right hernias (3/31, 9.7%). Among the three patients, two patients with a direct type had the same type of hernia as on the contralateral side (2/10, 20%). Another one patient with an indirect type had direct type of hernia on the contralateral side (1/21, 4.8%). Conclusion: Given the low incidence of contralateral side occult hernia with indirect types of hernias, routine exploration may not be indicated during TEP repair. However, it might be, reasonable to explore the contralateral side in patients with a direct type of hernia because of the higher incidence of contralateral occult hernias.

Keywords Laparoscopic herniorrhaphy, Totally extraperitoneal repair, Contralateral, Occult hernia

Article

Original Article

J Minim Invasive Surg 2009; 12(1): 50-53

Published online June 15, 2009

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

복막외 접근법에 의한 좌측 서혜부 탈장수술 시 반대편 탈장 검색의 의의

정춘식ㆍ이정은ㆍ조용걸ㆍ유상화ㆍ정규영ㆍ김승한ㆍ이동근

한솔병원 외과

The Incidence of the Occult Contralateral Hernia in Patients Undergoing Total Extraperitoneal (TEP) Repair of a Left Inguinal Hernia

Choon Sik Chung, M.D., Jeong Eun Lee, M.D., Yong Geul Joh, M.D., Sang Hwa Yu, M.D., Gyu Young Jeong, M.D., Seung Han Kim, M.D., Dong Keun Lee, M.D.

Department of Surgery, Hansol Hospital, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Laparoscopic herniorrhaphy (LH) can be used to examine the asymptomatic contralateral side and repair occult contralateral hernias coincidentally with reduced morbidity. In this prospective study, we evaluated the results of diagnostic exploration of the right side during total extraperitoneal (TEP) laparoscopic repair of left side inguinal hernias. Methods: A prospective study of 100 consecutive male patients undergoing TEP repair by a single surgeon (C.S) between January and June 2008 was conducted. Two cases that had transabdominal preperitoneal (TAPP) prosthetic repair and one intraperitoneal onlay mesh (IPOM) were excluded. We routinely explored the contralateral side to determine the incidence of right side occult hernia. Results: The mean age was 52 (range; 18∼82 years). Among the 100 patients, 17 had bilateral, 52 right and 31 left hernias on physical examination prior to surgery. Three of 31 diagnosed preoperatively as left inguinal hernia were confirmed to have occult right hernias (3/31, 9.7%). Among the three patients, two patients with a direct type had the same type of hernia as on the contralateral side (2/10, 20%). Another one patient with an indirect type had direct type of hernia on the contralateral side (1/21, 4.8%). Conclusion: Given the low incidence of contralateral side occult hernia with indirect types of hernias, routine exploration may not be indicated during TEP repair. However, it might be, reasonable to explore the contralateral side in patients with a direct type of hernia because of the higher incidence of contralateral occult hernias.

Keywords: Laparoscopic herniorrhaphy, Totally extraperitoneal repair, Contralateral, Occult hernia

Share this article on

  • kakao talk
  • line

Related articles in JMIS

Journal of Minimally Invasive Surgery

pISSN 2234-778X
eISSN 2234-5248