Previous Laparoscopic Inguinal Hernia Repair Does Not Adversely Affect the Functional or Oncological Outcomes of Endoscopic Extraperitoneal Radical Prostatectomy

Objective To investigate whether previous laparoscopic inguinal hernia repair (LIHR) affected adversely key outcome measures in radical prostatectomy, including perioperative data, pathologic data, complications, potency, continence, and prostate-specific antigen (PSA). We have shown previously that LIHR does not preclude safe endoscopic extraperitoneal radical prostatectomy (EERPE). Methods EERPE is the standard approach to radical prostatectomy in our unit. Between 2001 and June 2009 we encountered 92 patients who had previously undergone LIHR who underwent our standard technique of EERPE other than modification of port placement and development of the extraperitoneal space. We recorded our standard perioperative/postoperative dataset. Twelve-month follow-up data were available from 75 of 92 patients with 6-month follow-up of the remaining 17. Results Fifty-nine patients had undergone previous unilateral total extraperitoneal hernioplasty (TEP): 16 bilateral TEP, 15 unilateral transabdominal extraperitoneal hernioplasty (TAPP), and 2 bilateral TAPP. Although we needed to modify our technique, there was no increase in our operative time (153 minutes). Where indicated, we were able to perform bilateral nerve sparing and pelvic lymphadenectomy on the contralateral side to the LIHR. There were no major complications and no blood transfusions. Our positive margin rate, continence, and potency rates did not differ from our series of 2000 consecutive EERPEs. Ninety-four-point-seven percent of men had an undetectable PSA at 12 months. Conclusions LIHR does not adversely affect perioperative and key outcome measures in EERPE. To investigate whether previous laparoscopic inguinal hernia repair (LIHR) affected adversely key outcome measures in radical prostatectomy, including perioperative data, pathologic data, complications, potency, continence, and prostate-specific antigen (PSA). We have shown previously that LIHR does not preclude safe endoscopic extraperitoneal radical prostatectomy (EERPE). EERPE is the standard approach to radical prostatectomy in our unit. Between 2001 and June 2009 we encountered 92 patients who had previously undergone LIHR who underwent our standard technique of EERPE other than modification of port placement and development of the extraperitoneal space. We recorded our standard perioperative/postoperative dataset. Twelve-month follow-up data were available from 75 of 92 patients with 6-month follow-up of the remaining 17. Fifty-nine patients had undergone previous unilateral total extraperitoneal hernioplasty (TEP): 16 bilateral TEP, 15 unilateral transabdominal extraperitoneal hernioplasty (TAPP), and 2 bilateral TAPP. Although we needed to modify our technique, there was no increase in our operative time (153 minutes). Where indicated, we were able to perform bilateral nerve sparing and pelvic lymphadenectomy on the contralateral side to the LIHR. There were no major complications and no blood transfusions. Our positive margin rate, continence, and potency rates did not differ from our series of 2000 consecutive EERPEs. Ninety-four-point-seven percent of men had an undetectable PSA at 12 months. LIHR does not adversely affect perioperative and key outcome measures in EERPE.