Posters
Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P061: ROBOTIC ASSISTED LAPAROSCOPIC GROIN HERNIA REPAIR AFTER PREVIOUS ABDOMINAL PROSTATECTOMY
Filip Muysoms, PhD; Lore Aspeslagh, MD; Femke Nachtergaele, MSc; Barbara Defoort, MD; Pieter Pletinckx, MD; Maria Middelares Ghent Belgium
Background: Abdominal prostatectomy results in scaring of the retropubic space and this might complicate subsequent preperitoneal dissection and mesh placement during groin hernia repair. Therefor it is suggested that an anterior open technique should be considered rather than a laparoscopic posterior technique.
Methods: A retrospective review of a prospective database on all patients undergoing groin hernia repair after previous abdominal prostatectomy was performed to investigate the safety of laparoscopic groin hernia repair compared to open repair after introduction of robotic assisted groin hernia surgery.
Results: From 907 groin hernia operations performed between March 2015 and March 2020, 45 patients with a history of abdominal prostatectomy were identified. An anterior open approach with mesh (Lichtenstein) was performed in 21 patients and a laparoscopic approach (TAPP) in 24 (2 conventional laparoscopic and 22 robotic assisted). There were no differences in baseline data between the two groups. More patients in the TAPP group underwent a bilateral repair (46%) than in the Lichtenstein group (19%). The previous abdominal prostatectomy was performed open in 25 patients (56%) and robot assisted in 20 patients (44%). There were no intraoperative complications and no conversions from laparoscopy to open surgery. Hospital stay in days was 1.1 (SD 0.7) for the open group and 1.0 (SD 0.8) for the laparoscopic group. The operation was performed with less than 24 hours stay in 84%. Urinary retention requiring urinary catheterization was the only early postoperative complication noted in 1 patient. At 4 weeks follow-up, 7 patients (16%) had an asymptomatic seroma. A transurethral bladder catheter was placed during surgery in 19 patients, most often in the laparoscopic cases (17/24, 71%) and 2 patients were treated postoperatively for a urinary tract infection (2/18 patients, 11%).
Conclusion: A robotic assisted laparoscopic approach to groin hernias after previous abdominal prostatectomy is feasible and safe. We think it might have advantages mainly for bilateral groin hernia repairs.
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