Feasibile study of laparoscopic totally extra-peritoneal in patients with a history of lower abdominal surgery

ObjectiveTo explore the feasibility of laparoscopic totally extra-peritoneal(TEP)in patients with a history of lower abdominal surgery.

MethodsAmong 387 patients scheduled by TEP from January 2018 to December 2018, 64 patients with a history of lower abdominal surgery were selected, and the perioperative situation and postoperative following-up were analyzed.

ResultsSixty-four patients(53 males and 11 females)were selected, the operative time and intraoperative blood loss were(50.05±19.28)min and(7.27±5.64)mL, respectively.The TEP in 60 cases were successfully completed.Three cases were converted to open repair, 1 case was converted to laparoscopic trans-abdominal preperitoneal hernia repair, and the 4 cases had a history of prostate cancer.The postoperative hospitalization duration of patients was(1.17±0.68)d, 1 case of seroma, 1 case of umbilical cord incision infection and 5 cases of urinary retention were identified.No chronic pain, patch infection, intestinal adhesion and recurrence in all cases were found.

ConclusionsTEP is safe and feasible for the majority of inguinal hernia patients with a historyof lower abdominal surgery.Before surgery, the surgeon should carefully evaluate the impact of previous surgery on the anatomical level and surgical field, and master the anatomy of the inguinal region and application of laparoscopy.