Preserving round ligament of uterus in laparoscopic repair of female groin hernia: A prospective study | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 41, Issue 3, April 2023 PDF (597.59 K) | ||||
| DOI: 10.4103/ejs.ejs_192_22 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ahmed H. Amer; Mahmoud A. Eissa; Sherif A. Sabir; ElGhamry E. ElGhamry | ||||
| Abstract | ||||
| Background Preserving the round ligament during Trans Abdominal Pre Peritoneal laparoscopic hernia repair (TAPP) surgery may be unfeasible or prolong the duration of surgery because of the adhesions between the round ligament and hernial sac, so the benefit of preserving or cutting the round ligament during dissection and spreading the mesh is a matter of debate. Patients and methods A case series study was conducted on 20 adult female patients over 6 months, and the transabdominal (TAPP) approach was used for all patients. After identifying the round ligament and dissecting it carefully from the adherent peritoneum trying not to tear the peritoneum, the mesh was fashioned to cover the areas of weakness that can develop hernia and cover the round ligament without making a keyhole for it. Results Follow-up was done for at least 6 months with no evident recurrence. No complications were recorded except for residual swelling postoperatively in six cases, sometimes with skin ecchymosis. This situation was managed conservatively and resolved within 2 weeks. Overall, seven patients complained of mild pain (1–2) score, and only one patient was still complaining after 6 months; the pain was mild and well tolerated by the patient and generally did not affect patient satisfaction Conclusion TAPP laparoscopic repair of female inguinal hernia preserving the round ligament is feasible, although can be trickier and more difficult than scarifying it. The recurrence rate is low with good patient satisfaction. It seems there is no evident superiority of preserving the ligament, but we recommend more studies with longer follow-up and more cases to figure out the long-term effect of preserving the ligament. | ||||
| Keywords | ||||
| Female; laparoscopic hernia repair; round ligament; total extraperitoneal | ||||
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