Is Minimally Invasive Hernia Repair Safe in Patients With Previous Prostate Surgery?

Aim Laparoscopic inguinal hernia repair after previous radical prostatectomy is considered complex due to the subsequent preperitoneal fibrotic reaction. For this reason, it has been considered a contraindication, and many surgeons have opted for open surgery. The aim of this study is to describe the outcomes of inguinal hernia repair after previous prostate surgery in our center. Patients and Methods We retrospectively analyzed a total of 566 patients who underwent inguinal hernia repair during a 1 year period (from May 2022 to May 2023). Patients with previous radical prostatectomy were identified, and outcomes of laparoscopic versus open hernia repair techniques were compared. Results Twenty-three patients with prior prostate surgery were identified, among whom four underwent minimally invasive repair (MIS) (17%; 2 TEP and 2 TAPP). Longer mean operative time was observed in the MIS group (100 min) compared to the open surgery (67 min). There were no MIS to open conversions. Perioperative complications included 1 bladder injury and 2 seromas in the MIS group, and 1 hematoma and 1 recurrence in the open group. Conclusions MIS for inguinal hernia after prostate surgery remains infrequent in our experience. Although MIS hernia repair after prostatectomy is considered safe, potentially serious complications may arise, and care must be taken regarding patient selection and operative management.