COMPARING OUTCOMES AFTER LAPAROSCOPIC TOTALLY EXTRAPERITONEAL REPAIR VERSUS OPEN (LICHTENSTEIN) REPAIR OF INGUINOSCROTAL HERNIA AT DR GEORGE MUKHARI ACADEMIC HOSPITAL.

BACKGROUND: Inguinal hernia is a common surgical condition. Inguinal hernia can present with a wide variety of symptoms. It can even extend into the scrotum resulting in what is known as an inguinoscrotal hernia. At Dr George Mukhari Hospital, approximately 5-10% of patients with inguinal hernia present with inguinoscrotal hernia. There is paucity of data on the role of laparoscopy in the management of inguinoscrotal hernia. At our institution some of the patients with inguinoscrotal hernia are offered open (Lichtenstein) repair whilst others are offered totally extraperitoneal (TEP) laparoscopic repair.

METHOD: We retrospectively reviewed patients' charts to collect information on demographics, comorbidities, smoking history, type of repair, operative time and length of hospital stay from 2014 to 2017. Patients were followed up telephonically for up to 3 years. With the telephonic follow-up we collected data on the time taken to resume normal activities after hernia repair, chronic groin pain, recurrence and seroma formation.

RESULTS: Seventeen patients were offered open repair and 13 were offered laparoscopic repair. Average age for patients offered laparoscopic repair was 48 years compared to 40 years in the open group. Operative time was longer with laparoscopic repair. In both groups, patients stayed one day in the hospital post repair. Time taken to return to normal activities was longer with open repair. Sixty-two percent of patients in the laparoscopic arm compared to 88% of patients in the open arm were treated without postoperative complications. Two patients had recurrence, two had chronic groin pain and one developed seroma in the laparoscopic group versus one who had recurrence, one had chronic groin pain and none had seroma in the open group. No mortality was observed in both groups.

CONCLUSION: Through our study we were able to show that laparoscopic repair of inguinoscrotal hernia is safe and has comparable postoperative complications to open repair. More studies are still needed on the role of laparoscopy in repairing inguinoscrotal hernia.