Does Prior Lower Abdominal Surgery Prevent Laparoscopic Hernia Repair (Totally Extraperitoneal or Transabdominal Preperitoneal)? A Prospective Observational Study.

Abstract

Objective: Totally extraperitoneal (TEP) surgeries were considered contraindicated in patients who underwent lower abdominal surgery until recently. However, in recent surgeries, it has been reported that they can be performed safely in those cases. Our aim in this study is to investigate the effectiveness of laparoscopic hernia repair methods in patients who have and have not had lower abdominal surgery before. Patients and Method: This study was a prospective observational study between May 2018 and May 2023. Two hundred eighty-eight patients were included in the study. The operation was started with the TEP technique in all patients. Patients, classified in two groups who had not previously undergone abdominal surgery (n = 216) (Group I) and who had surgery (n = 72) (Group II). Demographic characteristics of patients, intraoperative and postoperative complications were determined. In addition to descriptive statistical methods (mean, standard deviation), Shapiro-Wilk normality test, independent t test, and chi-square test were used to evaluate the data. Logistic regression analysis was performed to determine the factors affecting the presence of Previous Surgery and Peritoneal Tear. Results were evaluated at the significance level of P < .05. Results: Two hundred fifty-nine patients were operated with TEP method. TEP method was converted to transabdominal preperitoneal (TAPP) in 9 patients from Group I and 20 patients from Group II. Intraoperative and postoperative complications were recorded. Conclusion: With increasing experience in laparoscopic hernia surgery, it is now possible to perform hernia surgeries with preperitoneal (TEP) and abdominal approaches (TAPP) in patients who have previously undergone lower abdominal surgery.