title: Massive scrotal hernias: problems and solutions.
abstract: BACKGROUND
  Massive incarcerated scrotal hernias are usually managed by an open method. Some experienced surgeons have successfully attempted laparoscopic management of such cases. Total extraperitoneal repair (TEP) is the laparoscopic technique of choice for the repair of groin hernia. Many authors have suggested that transabdominal preperitoneal (TAPP) is the preferred approach to these hernias. The purpose of this study is to show our results of TEP repair of giant scrotal hernias.
  
  
  METHODS
  In the present study a total of 21 (20 patients) out of 291 groin hernias (185 patients) were included and evaluated prospectively. TEP was successful in 14 (66.6%) with a conversion to TAPP in 4 (19.04%) and open procedure in 3 (14.28%) cases, respectively. Postoperative complications included scrotal hematoma in 5 (25%), spermatic cord edema in 6 (30%), and seroma in 14 (70%) patients. There was no recurrence of hernia noticed during mean follow-up of 36 months (range, 22-51).
  
  
  CONCLUSIONS
  Laparoscopic TEP repair was successful with excellent outcome in the management of massive incarcerated groin hernia in the hands of an experienced laparoscopic surgeon.
authors.affiliation: Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India. mcmisra@gmail.com
authors.forename: Mahesh C
authors.initials: MC
authors.lastname: Misra
authors.forename: Prashant Dayalrao
authors.initials: PD
authors.lastname: Bhowate
authors.forename: Virinder Kumar
authors.initials: VK
authors.lastname: Bansal
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005500:Follow-Up Studies; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012611:Scrotum; D016896:Treatment Outcome