Minimally Invasive Surgery in the Management of Inguinoscrotal Hernias. Our Experience

Abstract Aim Inguinoscrotal hernias have higher postoperative complication rate, and more general complications than inguinal hernias. The latest European Hernia Society’s guidelines suggest open repair but minimally invasive techniques can be safely employed with low complications rates. The aim of our study is to analyzed minimally invasive approach of inguinoscrotal hernias in our experience. Material and Methods A retrospective analysis of a prospectively maintained Abdominal Wall Unit database from January 2020 to July 2023. All inguinoscrotal hernias classified according to the Kingsnorth´s modified score with H3 or H4 for groin hernia were included. We performed a comparative analysis of open (OPEN group) vs. minimally invasive repair (MIS group). Demographics, comorbidities and hernia characteristics and outcomes were analyzed. Results 65 cases were included. 50 cases (76.9%) an open repair was performed vs. 15 cases (23%) with minimally invasive surgery (either laparoscopic or robotic surgery). The groups were homogeneous except for a higher rate of recurrent hernias (40% vs. 10%; p = 0.014), bilateral hernias (86% vs. 28%; p = 0.001), associated ventral hernia repair (46,7% vs. 10%; p = 0.004) in MIS group, on the other hand hernias were irreducible more frequently in OPEN group (86 vs. 6,7%; p = 001). No significant statistical differences of outcomes were observed between groups except for longer operation mean time (135 +/-50 vs. 95+/-40 min; p = 0.003). Conclusions Minimally invasive approach can be beneficial in cases with bilateral groin hernia, recurrent or with ventral hernia associated repair and be safely employed by experienced surgeons with no added postoperative complication compared to open surgery.