A New Approach and Old Techniques: Combined Endoscopic Repair of Inguinoscrotal Hernias.

Abstract

The treatment of inguinoscrotal hernias (ISH) represents one of the most challenging areas in surgical pathology. Although these hernias could be repaired through a minimally invasive approach, open repair is still considered to be the technique of choice for most surgeons. The purpose of this study is to evaluate our new combined [open+transabdominal preperitoneal (TAPP)/total preperitoneal (TEP)] method of ISH repair. The authors reviewed the charts of 124 patients with ISH who underwent hernia repair in different modifications: open, TAPP, TEP, and new combined method with a minimal follow-up of 3 months. New combined (open+TAPP/TEP) method repair was successful in all 38 patients. Average case duration was 68.8 minutes (62 to 106 min). No recurrence was observed for the 13 months follow-up. Two patients had intraoperative serosal bowel injury, 1 patient developed postoperative seroma, and 2 patients developed several pain. Combined (open+TAPP/TEP) method for ISH repair allows to minimize surgical trauma and reduce both the procedure time and the postoperative length of stay. Implementation of this method results in statistically significantly fewer wound-related postoperative complications compared with traditional methods.