Tumescent TAPP: laparoscopic inguinal hernia repair after the preperitoneal tumescent injection of diluted lidocaine and epinephrine saline solution and carbon dioxide gas

Hiromi Tokumura, Ryohei Nomura, Fumito Saijo, Naoki Matsumura, Akihiro Yasumoto, Mitsuhisa Muto, Yu Katayose, Kennichi Takahashi, Sho Haneda

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) is technically difficult and not infrequently followed by postoperative complications and pain, especially when performed by inexperienced surgeons. To simplify TAPP and reduce postoperative pain, we devised a novel procedure whereby TAPP is carried out after the inguinal preperitoneal infiltration of diluted lidocaine and epinephrine saline solution and carbon dioxide gas (tumescent TAPP). This report introduces the concept of tumescent TAPP and summarizes its operative results. Methods: About 120 ml of diluted lidocaine and epinephrine solution and 60 ml of CO2 gas were infiltrated into the inguinal preperitoneal space through a transabdominal needle before TAPP. Tumescent TAPP was performed for 400 patients (355 men, 45 women; mean age, 63.2 years). Results: Using tumescent TAPP, we found it easier to confirm the inguinal anatomy and dissect the preperitoneal layer and inguinal floor, with less bleeding. The mean operation time was 101.9 min and there were few perioperative complications and minimal pain. Conclusions: Tumescent TAPP makes conventional TAPP easier and safer; however, this procedure should be verified by a comparative study with conventional TAPP.

Original languageEnglish
Pages (from-to)52-57
Number of pages6
JournalSurgery today
Volume47
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1
Externally publishedYes

Keywords

  • Inguinal hernia
  • Tumescent laparoscopic transabdominal preperitoneal hernia repair
  • Tumescent local anesthesia

ASJC Scopus subject areas

  • Surgery

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