Inguinal hernia repair and laparoscopic radical extraperitoneal radical prostatectomy

Česká verzia

Authors: Petr Stránský; Tomáš Ürge; Ivan Trávníček; Tomáš Pitra; Hana Sedláčková; Milan Hora
Authors place of work: Urologická klinika LF UK a FN Plzeň
Published in the journal: Ces Urol 2019; 23(4): 333-340
Category: Original Articles

Summary

Introduction: Laparoscopic inguinal hernia repair is now a standard surgical technique in terms of safety, efficiency and potential risk of recurrence. The authors present the possibility of performing an inguinal hernia repair in combination with a laparoscopic radical extraperitoneal (preperitoneal) prostatectomy.

Material and methods: From June 2012 to August 2019 we performed 10 laparoscopic radical extraperitoneal prostatectomies with contemporary inguinal hernia repair at our institution. In most cases a self‑gripping polypropylene mesh ProGrip™ Covidien™ with polylactic acid grips was used for hernia repair.

Results: The mean age of the patients was 67 years (range 61–73 years), preoperative PSA value 10.29 µg / l (range 4.60–16.35 µg / l), operating time 155 minutes (range 107–190 min), average blood loss 470 ml (range 100–900 ml), prostate weight 60 g (range 32–136 g), hospitalization time 7.8 (range 5–13) days. Pelvic lymphadenectomy was performed in 2 cases. During the follow‑up period we have never observed mesh infection or hernia recurrence.

Conclusion: The combination of laparoscopic radical extraperitoneal prostatectomy and inguinal hernia repair is a safe and effective method. The patient benefits from only one general anesthesia, hernia surgery is relatively simple, the placement of the mesh does not require additional suture or clipping, the extraperitoneal approach eliminates any contact with the bowel and prevents the risk of adhesion formation. The hernia repair is performed after the completion of the prostatectomy (and lymphadenectomy). Oncological and functional outcomes of the radical prostatectomy do not seem to be influenced by the inguinal hernia repair.

Keywords:

inguinal hernia – laparoscopy – Radical prostatectomy – prostatae cancer – mesh application

Zdroje

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