Login to Access Video or Poster Abstract: MP97-17
Sources of Funding: This study was supported the Sidney Kimmel Center for Prostate and Urologic Cancers, the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748, and by David H. Koch through the Prostate Cancer Foundation.

Introduction

We sought to compare the safety and effectiveness of two techniques for minimally invasive inguinal hernia (IH) repair, intraperitoneal onlay mesh (IPOM) repair vs. suture repair, in patients undergoing concurrent robotic-assisted laparoscopic radical prostatectomy (RALP).

Methods

In a single tertiary-care institution study, we retrospectively identified patients who underwent RALP and minimally-invasive IH repair concurrently from 2010 to 2015. IH were repaired using either an IPOM or a running suture. We assessed the impact of the IH repair technique on perioperative outcomes, 90-day complications, and IH recurrence.

Results

Of 2,239 patients undergoing RALP during the study period, 51 patients (2.3%) underwent concurrent minimally invasive IH repair; 28 underwent IPOM repair, and 23 underwent suture repair. The proportion of patients with previous ipsilateral IH repair was higher in the IPOM group. We found no evidence of a significant difference in age, body mass index (BMI), preoperative physical exam findings, postoperative pain, or overall 90-day complication rates between the two groups. Operative time and length of hospitalization were significantly shorter in the IPOM group. Postoperative complications requiring intervention (Clavien-Dindo ≥ III) were more frequent in the suture group (p=0.03) The IH recurrence rate was lower in the IPOM group by a clinically relevant but not statistically significant difference (4% vs. 9%; p=0.58)

Conclusions

In patients undergoing RALP and IH repair, IPOM repair is feasible, and may be associated with better perioperative outcomes and safety profile than suture repair. The effectiveness of IPOM repair was superior but not significantly. A prospective comparison against the gold-standard technique is warranted.

Funding

This study was supported the Sidney Kimmel Center for Prostate and Urologic Cancers, the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748, and by David H. Koch through the Prostate Cancer Foundation.