Soler Marc, Gillion Jean Francois
Clinique Saint Jean, Cagnes-sur-Mer, France.
Antony Private Hospital, Antony, France.
J Abdom Wall Surg. 2025 Feb 20;4:13863. doi: 10.3389/jaws.2025.13863. eCollection 2025.
Minimally invasive open preperitoneal techniques are an alternative in groin hernia repair. Scrotal hernias (SH) are frequently difficult to repair laparoscopically, resulting in a significant conversion rate.
The aim of this exploratory monocentric retrospective study, based on data prospectively collected in the "Club-Hernie" registry, was to assess the feasibility, effectiveness and safety of the MOPP technique in SH repair compared with non-SH repair.
All consecutive MOPP repairs performed from 11 September 2011 to 31 December 2022 were identified in which 2005 MOPP (126 SH and 1879 non-SH) met the inclusion criteria. The results were analysed "as treated" in 125 SH vs. 1879 non-SH. No statistically significant difference was observed between these two groups in terms of age, BMI, and ASA classification. Symptomatic hernias (84% vs. 73%; p < 0.001), and lateral hernias (87.80% vs. 62.81%; p < 0.0001) were more frequent in the SH group. The mean operating time was longer (58 min vs. 39 min; p < 0.0001) in the SH group. The SH procedures were performed under general anaesthesia with a laryngeal mask in 92% of cases. All postoperative complications, except one reoperation in the non-SH group, were classified as Clavien-Dindo Grade I/II. Superficial surgical site occurrences were more frequent in the SH group (14% vs. 3%; p < 0.0001). No peri-prosthetic infections were observed. The outpatient rate was 83% vs. 94% in the SH and non-SH groups, respectively. There were four rehospitalisations in the non-SH group and none in the SH group. The postoperative pain was low and similar in the two groups, except at M1, where the mean pain was lower in the SH group (p < 0.001). A total of 113 (90%) patients in the SH group vs. 1,553 (82%) in the non-SH group were followed for 1 year or more. The number of identified recurrences and reoperations was low and did not differ between the two groups studied. In total, 98% of patients in both groups assessed their surgery as excellent or good.
This exploratory study shows that the MOPP technique is feasible and safe in scrotal hernia repair, with similar results to those observed in non-scrotal hernias. Our next step will be to compare MOPP with laparoscopic and Lichtenstein techniques in scrotal hernia repair.
微创开放腹膜前技术是腹股沟疝修补术的一种替代方法。阴囊疝（SH）通常难以通过腹腔镜修复，导致较高的中转率。
本探索性单中心回顾性研究基于“疝俱乐部”登记处前瞻性收集的数据，旨在评估与非阴囊疝修补相比，MOPP技术在阴囊疝修补中的可行性、有效性和安全性。
确定了2011年9月11日至2022年12月31日期间所有连续进行的MOPP修补术，其中2005例MOPP（126例阴囊疝和1879例非阴囊疝）符合纳入标准。对125例阴囊疝与1879例非阴囊疝进行“按治疗情况”分析。两组在年龄、体重指数和美国麻醉医师协会（ASA）分级方面未观察到统计学显著差异。阴囊疝组症状性疝（84%对73%；p<0.001）和外侧疝（87.80%对62.81%；p<0.0001）更为常见。阴囊疝组平均手术时间更长（58分钟对39分钟；p<0.0001）。92%的阴囊疝手术在全身麻醉下使用喉罩进行。除非阴囊疝组有1例再次手术外，所有术后并发症均分类为Clavien-Dindo I/II级。阴囊疝组手术部位浅表并发症更常见（14%对3%；p<0.0001）。未观察到假体周围感染。阴囊疝组和非阴囊疝组的门诊率分别为83%和94%。非阴囊疝组有4例再次住院，阴囊疝组无再次住院情况。两组术后疼痛程度较低且相似，但在术后1个月时，阴囊疝组平均疼痛程度较低（p<0.001）。阴囊疝组共有113例（90%）患者与非阴囊疝组的1553例（82%）患者随访1年或更长时间。确定的复发和再次手术病例数较少，两组之间无差异。总体而言，两组中98%的患者对手术评价为优秀或良好。
本探索性研究表明，MOPP技术在阴囊疝修补中可行且安全，结果与非阴囊疝修补相似。我们的下一步将是比较MOPP与腹腔镜和Lichtenstein技术在阴囊疝修补中的效果。
