A Novel Technique to Prevent Postradical Retropubic Prostatectomy Inguinal Hernia: The Processus Vaginalis Transection Method

Fujii, Yasuhisa; Yamamoto, Shinya; Yonese, Junji; Kawakami, Satoru; Okubo, Yuhei; Suyama, Taisuke; Komai, Yoshinobu; Kijima, Toshiki; Fukui, Iwao

doi:10.1016/j.urology.2009.05.051

Cited by 44 publications

(24 citation statements)

References 14 publications

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“…Stranne et al [19] showed that narrowing the IIR with non-absorbable figure-of-8 suture led to decreased IH incidence in a large prospective study. Recently, non-mesh techniques have been reported [8][9][10] . The concept of these techniques was separation from the peritoneum and division of the continuity between processus vaginalis and peritoneum.…”

Section: Discussionmentioning

confidence: 99%

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Incidence, Risk Factors and a Novel Prevention Technique for Inguinal Hernia after Robot-Assisted Radical Prostatectomy

Shimbo

Endo²,

Matsushita³

et al. 2016

Urol Int

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Introduction: To evaluate the incidence and risk factors for postoperative inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) and to assess whether a newly developed prevention technique reduces the incidence of IH after RARP. Methods: We included 161 consecutive patients (322 groins) who underwent RARP between September 2011 and October 2013. The prevention technique was as follows: (1) sufficient incision of peritoneum around the internal inguinal ring; (2) separation of spermatic vessels; (3) dissection of vas deferens. Results: Postoperative IH occurred in 14 cases (19.4%) occurring in the observation group compared to 2 cases (2.2%) in the prevention group. Patent processus vaginalis (PPV) was the only risk factor. Time-to-event analysis demonstrated a significant decrease in IH incidence in the IH prevention group (p = 0.005). Conclusion: Our data reveal a higher incidence of IH after RARP, with the existence of PPV as the only identified risk factor. Our simple IH-prevention technique, which does not involve the use of artificial materials, appears safe and effective.

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Section: Discussionmentioning

confidence: 99%

“…The concept of these techniques was separation from the peritoneum and division of the continuity between processus vaginalis and peritoneum. Fujii et al [8] introduced dissection and ligation of the processus vaginalis, showing this to be very effective for IH prevention, as well as providing longterm effectiveness for IH prevention [20] .…”

Section: Discussionmentioning

confidence: 99%

Incidence, Risk Factors and a Novel Prevention Technique for Inguinal Hernia after Robot-Assisted Radical Prostatectomy

Shimbo

Endo²,

Matsushita³

et al. 2016

Urol Int

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“…Fujii et al reported the processus vaginalis transection method [7]. They showed the patients who underwent IH prevention were lower incidence of the postoperative IH than those who did not and the hernia-free survival rates for 1-, 2-, and 3-year were 87 %, 81 %, and 77 %, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first report by Regan et al in 1996 [1], the high incidence of postoperative inguinal hernia (IH) has been recognized as a common complication of RRP. The incidence of IH after RRP has been reported to range from 12 % to 38.7 % [1][2][3][4][5][6][7]. Furthermore, reportedly more than 90 % of IH after RRP was indirect hernia [4,6].…”

Section: Introductionmentioning

confidence: 99%

Prevention Technique of Postoperative Inguinal Hernia in Patients Undergoing Radical Prostatectomy for Localized Prostate Cancer

Oyama

Miyake

Toyoshima

et al. 2016

Indian J Surg Oncol

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To prevent inguinal hernia after retropubic radical prostatectomy, many urologists have utilized a prevention technique of inguinal hernia at the same time as retropubic radical prostatectomy. Here, we report the clinical benefit of the prevention technique of inguinal hernia as well as risk factors for the incidence of inguinal hernia. We investigated the medical records of 223 men who underwent retropubic radical prostatectomy for clinically localized prostate cancer between January 2007 and March 2013 at our medical center. We assessed the association between the postoperative inguinal hernia and variables such as age, body mass index, and previous abdominal surgery. Inguinal hernia-free survival was analyzed to verify risk factors of postoperative inguinal hernia. Of 223 patients, 67 (30 %) received prevention of inguinal hernia and 156 (70 %) did not. The median follow-up period after retropubic radical prostatectomy was 36 months (range, 3-58 months). Thirty one (14 %) patients developed unilateral or bilateral inguinal hernia after retropubic radical prostatectomy. The rate of postoperative inguinal hernia in prevented and non-prevented group was 3 % (2 of 67) and 19 % (29 of 156), respectively (P < 0.01, Mann-Whitney U test). Moreover, postoperative inguinal hernia-free survival in the prevention group was significantly longer than that in the nonprevented group (P < 0.01, log-rank test). In the prevention group, 1-, 2-, and 3-year inguinal hernia-free survival rates were 100 %, 96 %, and 96 %, respectively. Other clinical factors including age, body mass index, previous abdominal surgery, and previous inguinal hernia were not associated with the incidence of inguinal hernia in our cohort. The prevention technique was simple and safe to perform, and it could increase inguinal hernia-free survival rates after retropubic radical prostatectomy.

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“…Fujii et al [18] speculated that the processus vaginalis is a key target for preventing post-RRP indirect IH. They dissected and ligated the processus vaginalis as a hernia prevention procedure in 138 patients.…”

Section: Discussionmentioning

confidence: 99%

Simple method for preventing inguinal hernias after radical retropubic prostatectomy

Koike

Matsui

Morikawa

et al. 2013

Prostate International

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Purpose:Inguinal hernias often occur after radical retropubic prostatectomy (RRP). We present a novel and simple technique for preventing inguinal hernias after RRP, which any surgeon can complete within a few minutes.Methods:A total of 230 Japanese prostate cancer patients underwent RRP between January 2007 and September 2011. From July 2009, 115 patients underwent inguinal hernia prevention procedures at the same time as RRP. In this procedure, we released approximately 5 cm of the bilateral vas deferens and spermatic vessels from the peritoneum. In cases in which the processus vaginalis had spread into the abdomen, we ligated it close to the peritoneal cavity and then transected it. The remaining 115 patients who underwent RRP but did not undergo the hernia prevention procedure were used as the control group. The incidence rate of postoperative inguinal hernia was compared between the 2 groups.Results:Inguinal hernias developed during the postoperative follow-up period in 18 of the 115 control patients (15.7%) (median duration, 50 months). The hernia-free survival rate of this group was 89.6% and 84.1% at 1 and 2 postoperative years, respectively. In contrast, only 1 of the 115 patients (0.87%) who underwent the hernia prevention procedure developed an inguinal hernia during the follow-up period (median duration, 27 months). The hernia-free survival rate of this group was 100% at both 1 and 2 postoperative years (P<0.0001).Conclusions:We developed a simple method for preventing post-RRP inguinal hernias. The procedure is easy to perform and produces excellent outcomes.

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A Novel Technique to Prevent Postradical Retropubic Prostatectomy Inguinal Hernia: The Processus Vaginalis Transection Method

Cited by 44 publications

References 14 publications

Incidence, Risk Factors and a Novel Prevention Technique for Inguinal Hernia after Robot-Assisted Radical Prostatectomy

Incidence, Risk Factors and a Novel Prevention Technique for Inguinal Hernia after Robot-Assisted Radical Prostatectomy

Prevention Technique of Postoperative Inguinal Hernia in Patients Undergoing Radical Prostatectomy for Localized Prostate Cancer

Simple method for preventing inguinal hernias after radical retropubic prostatectomy

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