ModeratorMarch 7, 2015 at 7:17 pm
Concerns with laparoscopic repair
Any “posterior” repair may have a risk of disrupting the peritoneum and this a risk of the mesh coming in contact with the intestine. So a laparoscopic repair (TEP or TAPP) or an open repair with a posterior component (PHS, Plug, Kugel) can all have this risk. This is rare and even if it happens it is even more rare for it to cause an intestinal obstruction. The peritoneum may tear due to technique or a lot of scar tissue. Also, some people have really thin peritoneum and are at higher risk for the peritoneum to tear. It is unpredictable. In my mind this concern is certainly not a reason to choose lap vs open repair. There are much more important differences in risks and benefits that should be considered when choosing what is best for you.
Regarding the femoral nerve: injury to that would be a reportable case. I have seen it but it should never happen. It actually is more likely to happen with open repair due to too lateral of a stitching or too tight of a stitching. Once again: almost never an issue. The femoral nerve is a deep structure and lateral, so it is very difficult to injury it laparoscopically.