Slovenská chirurgia 2/2013

Laparoscopic TAPP treatment of sportsman`s hernia modified by the inguina release procedure

The sportsman‘s hernia or Gilmore‘s groin is a term used to describe a poorly defined, syndrome of painful symptoms relating to the inguinal region around the inguinal ligament without a clinically recognisable hernia. The term sportsman‘s hernia, or Gilmore‘s groin, was first described by O.J. Gilmore in 1980. Painful symptoms resulting from a weakening or disruption of the musculotendinous part of the posterior wall inguinal field, which is the cause of persistent pain in athletes in this way. The laparoscopic technique for the inguinal ligament release followed by mesh reinforcement, has been developed in Leicester, UK. Laparoscopic application of the ultrapro mesh by TAPP technique which is modified by the iguinal release procedure according to Lloyd creates a presumption to treat pain and stabilize the affected area. Material and methods: From January 1998 to December 2011, 1473 patients underwent operations using TAPP laparoscopic technique. 19 patients have been indicated to laparoscopic TAPP therapy with the clinical diagnosis of sportsmans hernia, without improving the difficulties after the conservative therapy. 4 patients have been carried out using double-sided output, 9 patients have been treated with operation therapy on the right side, and 5 patients on the left side. All patientshad actively devoted themselves to the sport, 11 patients on the amateur basis and 8 patients professionally. There have been 14 footballers and 5 hockey players. To stabilize the inguinal area in all cases 10 x 15 cm Ultrapro mesh by TAPP technique has been used. 5 patients have undergone inguinal release procedure. Results: All patients were discharged without complication on the first postoperative day. 5 professional athletes have been monitored due the effects of the surgery and have returned to full-time sports activity. 4 patients after double-sided output have returned to full athletic activity 4 weeks after the operation. There was no pain in one patient during a month but subsequently a pain in the anterio part of the pubic bone has been observed and requiring reoperation due such a relaps. Conclusion: The mini-invasive approach in the treatment of the sportsmans hernia is a safe and effective method, which brings significant improvement in symptoms and a rapid return to full athletic activities. Effective mini-invasive method with the quick return to the sports activity has particular importance among professional athletes.

Keywords: sportsman‘s hernia, inguina release procedure, laparoscopic TAPP treatment.