Klinik Bedah Digestif Bedah Saluran Cerna
Adeodatus Yuda Handaya
Division of Digestive Surgery, Department of Surgery, Dr. Sardjito Hospital/Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Yogyakarta, Indonesia
Abstract:
Abstract Background and Objectives: Hypertrophy Prostate and inguinal hernia are common health issues in men aged more than 50 years. Recently, more data are accumulating that prostatectomy and laparoscopic inguinal hernia repair (LIHR) can be performed in the same operation. This report depicts rejected mesh after the concomitant repair of a bilateral direct inguinal hernia with totally exstraperitoneal procedure (TEP) by using the mesh and trans ureteral prostatectomy (TURP). Methods: A 66-year-old man with bilateral direct inguinal hernia and enlargement of the prostate was performed with totally exstraperitoneal procedure (TEP) by using the mesh and trans ureteral prostatectomy (TURP). To minimize the risk of infection of the mesh, trans uretral prostatectomy was performed in the standard fashion after which laparoscopic transperitoneal access was obtained for the hernia repair. The laparoscopic bilateral hernia repair was completed by reduction of the hernia sac, followed by prosthetic mesh onlay. A single preoperative and postoperative dose of levofloxasin was administered.
Results: The procedure Laparoscopic TEP and TURP was completed with no difficulty. Total operative time was 3 hours with an estimated blood loss of 100 mL. The final pathology revealed no prostate cancer but the PSA 29mm/dl. Hematoma right inguinal occurred 3 weeks after procedure, Bilateral inguinal abcess and sepsis occurred at 3-month follow-up, we performed laparotomy mess evacuation and debridement, no evidences of recurrence of the hernia after mesh evacuation
Conclusion: Concomitant intraperitoneal totally exstraperitoneal procedure (TEP) by using the mesh and trans ureteral prostatectomy (TURP) are feasible. Increasing PSA and suspected prostate carcinoma can increase the risk of potential infectious complications by micro perforation prostate capsule cause infecting urine to the mesh at the space of Retzius. Mesh evacuation and abcess drainage procedure is performed and the pasien have a good result. Keywords Laparoscopy, Bilateral Inguinal hernia, Prostate Hypertropy,Rejected Mesh
(PDF) Rejected Mesh Post laparoscopic Totally Extraperitoneal Herniorepair Combining Trans Uretral Prostatectomy. Available from: