title: Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study).
abstract: BACKGROUND
  Chronic inguinal pain is a frequently occurring problem in athletes. A diagnosis of inguinal disruption is performed by exclusion of other conditions causing groin pain. Up to now, conservative medical management is considered to be the primary treatment for this condition. Relevant large and prospective clinical studies regarding the treatment of inguinal disruption are limited; however, recent studies have shown the benefits of the totally extraperitoneal patch (TEP) technique.This study provides a complete assessment of the inguinal area in athletes with chronic inguinal pain before and after treatment with the TEP hernia repair technique.
  
  
  METHODS
  We describe the rationale and design of an observational cohort study for surgical treatment with the endoscopic TEP hernia repair technique in athletes with a painful groin (inguinal disruption).The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18 years, suffering from inguinal pain for at least 3 months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by physical examination, inguinal ultrasound, X-pelvis/hip or MRI are excluded.Primary outcome is reduction in pain after 3 months. Secondary outcomes are pain reduction, physical functioning, and resumption of sport (in frequency and intensity).
  
  
  BACKGROUND
  An unrestricted research grant for general study purposes was assigned to the Hernia Centre. This study itself is not directly subject to the above mentioned research grant or any other financial sponsorship. We intend to publish the outcome of the study, regardless of the findings. All authors will give final approval of the manuscript version to be published.
authors.affiliation: Department of Surgery, Diakonessenhuis, Utrecht/Zeist, Zeist, The Netherlands.
authors.forename: C E H
authors.initials: CE
authors.lastname: Voorbrood
authors.affiliation: KNVB/FIFA Medical Centre of Excellence (Sport Medical Centre of the Royal Netherlands Football Association/FIFA Medical Centre of Excellence), Zeist, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Goedhart
authors.affiliation: Department of Surgery, Diakonessenhuis, Utrecht/Zeist, Zeist, The Netherlands.
authors.forename: E J M M
authors.initials: EJ
authors.lastname: Verleisdonk
authors.affiliation: Department of Radiology, Diakonessenhuis Utrecht/Zeist, Zeist, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Sanders
authors.affiliation: Department of Radiology, Diakonessenhuis Utrecht/Zeist, Zeist, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Naafs
authors.affiliation: Department of Surgery, Diakonessenhuis, Utrecht/Zeist, Zeist, The Netherlands.
authors.forename: J P J
authors.initials: JP
authors.lastname: Burgmans
mesh_terms: D001265:Athletic Injuries / Q000150:complications / Q000601:surgery*; D059350:Chronic Pain / Q000209:etiology / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods*; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life; D000068958:Return to Sport; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: inguinal disruption; inguinal pain; sportsman’s hernia; totally extraperitoneal patch (TEP) technique