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A Simple Procedure to Prevent Postoperative Inguinal Hernia after Robot-Assisted Laparoscopic Radical Prostatectomy: A Plugging Method of the Internal Inguinal Floor for Patients with Patent Processus Vaginalis

Authors
 Dong Hoon Lee  ;  Kyo Chul Koo  ;  Seung Hwan Lee  ;  Byung Ha Chung 
Citation
 JOURNAL OF UROLOGY, Vol.191(2) : 468-472, 2014 
Journal Title
 JOURNAL OF UROLOGY 
ISSN
 0022-5347 
Issue Date
2014
Keywords
BMI ; IH ; PPV ; PSA ; RALP ; RP ; body mass index ; hernia ; inguinal ; inguinal hernia ; laparoscopy ; patent processus vaginalis ; prostate specific antigen ; prostatectomy ; radical prostatectomy ; robot-assisted laparoscopic radical prostatectomy ; robotics
Abstract
PURPOSE: We introduce a simple procedure to prevent postoperative inguinal hernia after robot-assisted laparoscopic radical prostatectomy. We developed the inguinal hernia prevention procedure based on our prior study. Patent processus vaginalis is an independent predictor of inguinal hernia after robot-assisted laparoscopic radical prostatectomy. MATERIALS AND METHODS: We reviewed 74 patients (98 groins) with patent processus vaginalis during robot-assisted laparoscopic radical prostatectomy between May 2007 and April 2013. Of these patients 38 (47 groins) did not undergo the inguinal hernia prevention procedure and 36 (51 groins) were treated with this procedure. For the inguinal hernia prevention the lateral side internal inguinal floor of the patent processus vaginalis was incised and dissected along the spermatic cord. Hemostatic agents were plugged into the end of the dissected canal. After plugging, the internal inguinal floor was closed. We compared the incidence of postoperative inguinal hernia between the 2 groups. RESULTS: Among the 47 groins of the patients who did not undergo the inguinal hernia prevention procedure, postoperative inguinal hernia occurred in 16 groins (34.0%) and developed by a mean of 13.8 ± 8.5 months. In contrast, none of the patients who underwent the inguinal hernia prevention procedure experienced postoperative inguinal hernia during the followup of 11.8 ± 6.2 months. This inguinal hernia prevention procedure required approximately 3 extra minutes. During followup there were no intraoperative or postoperative complications related to the inguinal hernia prevention procedure. CONCLUSIONS: Using our simple inguinal hernia prevention procedure, the preventive effect was remarkable. However, studies in a larger patient population with a longer followup should be performed to prove the ultimate clinical impact of this inguinal hernia prevention procedure.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022534713054761
DOI
10.1016/j.juro.2013.09.035
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98952
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