title: Transabdominal preperitoneal laparoscopic approach for the treatment of sportsman's hernia.
abstract: BACKGROUND
  Groin pain in athletes presents a diagnostic and therapeutic challenge, particularly in distinguishing between those that will respond to nonoperative management and those that require surgery. Repair of sportsman's hernia, using the Modified Bassini darn or tension-free Lictenstein mesh technique, have been well described. The aim of this study was to assess the role of laparoscopy in the management of these hernias.
  
  
  METHODS
  Seventeen consecutive male patients (median age, 27 years), presenting with symptoms and signs of sportsman's hernia to a district general hospital were reviewed. Five patients presented with unilateral groin pain, whereas 12 had bilateral symptoms. All patients underwent a diagnostic laparoscopy, followed by transabdominal preperitoneal polypropelene mesh (15 x 10 cm) repair. All patients except 1 were discharged within 24 hours of surgery, and their rehabilitation was supervised by a single physiotherapist. All patients were assessed postoperatively by the authors and at a median follow-up of 23 weeks.
  
  
  RESULTS
  The laparoscopy confirmed posterior wall weakness in all patients with bilateral symptoms and in 4 of 5 patients with unilateral groin pain. Following repair, no surgical morbidity occurred and the median return to sporting activities was 42 days. All but 1 patient returned to the level of sport reached prior to injury, and mild pain was experienced in 5 groins, which did not interfere with either normal daily or sports activity.
  
  
  CONCLUSIONS
  The transabdominal preperitoneal laparoscopic approach is safe and feasible in the diagnosis and treatment of Sportsman's hernia, enabling a full return to sports activities.
authors.affiliation: Department of Biosurgery and Surgical Technology, Imperial College, London, London, UK. p.ziprin@imperial.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Ziprin
authors.forename: Shirish G
authors.initials: SG
authors.lastname: Prabhudesai
authors.forename: Solomon
authors.initials: S
authors.lastname: Abrahams
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Chadwick
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D006119:Groin / Q000601:surgery; D006552:Hernia, Inguinal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D018709:Statistics, Nonparametric; D016896:Treatment Outcome