P-033 RATIONALE FOR BILATERAL TAPP IN INGUINAL HERNIA AND NON-OVERGROWTH OF THE VAGINAL APPENDIX PERITONEUM ON THE CONTRALATERAL SIDE

Abstract

Abstract Introduction When performing TAPP overgrown vaginal appendage of the peritoneum is diagnosed on the contralateral side quite often. The question remains whether it is necessary to perform bilateral TAPP in unoccupied vaginal appendix. Aim To increase the effectiveness of TAPP in inguinal hernias combined with unhealed vaginal appendages contralaterally. Materials and methods An analysis of surgical treatment of 22 patients with bilateral TAPP who were diagnosed with vaginal appendix nonunion. All patients were men aged 25–65 years. Prior to surgery, it was agreed with patients that in case of nonunion of the vaginal appendix on the opposite side bilateral TAPP will be performed. For comparison, the efficacy of unilateral TAPP was evaluated in 21 patients with laparoscopically diagnosed non-overgrown vaginal appendix on the contralateral side. Results Among 22 patients with bilateral TAPP, the postoperative treatment was uncomplicated, postoperative pain was rated 2–3 points on a visual-analog scale. There was no postoperative wound infection. The duration of hospitalization was 2 + 1.2 days and was comparable to patients underwent unilateral TAPP. Long-term results were assessed by re-examinations and questionnaires, ultrasound examination, in 6–18 months. No complaints or recurrence of hernia were detected. A contralateral hernia developed in 9 (42.9%) patients of the control group at 6 to 12 months, which was scheduled for repeat TAPP. Conclusion TAPP requires diagnosis of bilateral inguinal area and bilateral TAPP in case of non-overgrowth of the vaginal peritoneal process, which reduces the likelihood of inguinal hernia on the contralateral side.