İbrahim H. Özata, Serkan Sucu, Salih N. Karahan, Bilge Kaan Kılıçoğlu, Mekselina Kalender, Furkan Camcı, Emre Özoran, Emre Bozkurt, Derya S. Uymaz, Orhan Ağcaoğlu, Emre Balık

Department of General Surgery, Koç University Faculty of Medicine, İstanbul, Türkiye


Objective: Laparoscopic totally extraperitoneal inguinal hernia repair (TEP) surgery technique includes three key steps: reaching the preperitoneal space, reducing hernias, and placement of mesh. However, reaching the preperitoneal space can be complicated in patients with previous lower abdominal surgeries. This study aimed to assess the feasibility of laparoscopic inguinal TEP in patients with previous prostatectomies.

Material and Methods: Inguinal hernia patients who underwent laparoscopic TEP between January 2015 and February 2021 at Koç University Faculty of Medicine, Department of General Surgery, were included in this retrospective study. The operations were performed by five senior surgeons experienced in laparoscopy. Patients were divided into two study groups, as the radical prostatectomy (RP) group which included patients with previous prostatectomy non-RP which included patients without previous radical prostatectomy. Operative time (OT), length of hospital stay (LOS), and postoperative complications were compared within two groups.

Results: Three hundred and forty-nine patients underwent laparoscopic TEP, and 27 had previous prostatectomies. Among them, 190 patients had unilateral inguinal hernias, and 159 had bilateral inguinal hernias. Mean age of the patients in the non-RP and RP groups was 58.1 ± 14.7 and 73.9 ± 9.6 years, respectively. Only one (3.7%) case was complicated with urinary tract infection in the RP group, and 10 (3.1%) were complicated in the non-RP group. Complications for the non-RP group include hematomas in six cases, urinary tract infection in three cases, and urinary retention in one case. No significant difference in mean operative time was seen between non-RP and RP groups (p= 0.43). There was no significant difference in the means of the length of hospital stay between the two groups (p= 0.7).

Conclusion: Laparoscopic TEP in patients with a previous prostatectomy can be performed safely without prolonging the operative time and increasing the length of hospital stay.

Keywords: Inguinal hernia, laparoscopic inguinal hernia surgery, benign prostate hyperplasia, totally extraperitoneal hernia repair

Cite this article as: Özata İH, Sucu S, Karahan SN, Kılıçoğlu BK, Kalender M, Camcı F, et al. Feasibility of totally extraperitoneal inguinal hernia repair in patients with previous prostatectomy. Turk J Surg 2023; 39 (3): 258-263.


Ethics Committee Approval

This study was approved by Koç University Ethics Committee (Decision no: 2022.440.IRB1.166, Date: 05.12.2022).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - İHÖ, SS, SK, BKK, MK, OA; Design - İHÖ, SS, EB; Supervision - İHÖ, EB, OA, DSU, EB, EÖ, FC; Data Collection and/or Processing - SS, SK, BKK, MK, FC, EÖ, EB, DSU; Analysis and/or Interpretation - İHÖ, EÖ, EB, DSU, OA; Literature Search - FC, SS, SK; Writing Manuscript - İHÖ, EÖ, MK, BKK; Critical Reviews - İHÖ, EÖ, EB, OA, EB, DSU.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.


The preliminary results from this study were presented in 15. Ulusal Endoskopik Laparoskopik Cerrahi Congress in 2021.