Transabdominal Preperitoneal Repair for Recurrent Inguinal Hernia Following Robot-Assisted Radical Prostatectomy and Prior Anterior Mesh Repair: A Case Report.

Abstract

Robot-assisted radical prostatectomy (RARP) is the standard treatment for prostate cancer; however, inguinal hernias (IH) development is a common complication. Current guidelines generally recommend an anterior approach following RARP for the initial IH. However, the optimal surgical strategy for patients with recurrent IH after RARP who have a history of anterior mesh repair remains unclear. This report describes the first successful transabdominal preperitoneal (TAPP) repair of a recurrent IH in a patient with a history of RARP and Kugel plug repair. Intraoperative findings revealed displacement of the mesh plug and recurrence of the IH (Japan Hernia Society classification R1, L2). The prevesical space was severely scarred because of the effects of RARP, making dissection of the inner side of the hernia orifice difficult; however, mesh placement was successfully completed. This case demonstrated the feasibility and efficacy of the TAPP approach as a radical treatment for complex recurrences in a specialized patient population.