Effective Closure of Peritoneal Tears During Totally Extraperitoneal Inguinal Hernia Repair With Bipolar Energy Devices: One-Year Follow-Up Results

BACKGROUNDS: This study aimed to present the clinical experience and long-term outcomes of managing small peritoneal tears (PT) during totally extraperitoneal (TEP) inguinal hernia repair using bipolar energy devices. METHODS: Patients who underwent TEP inguinal hernia repair at a tertiary center were retrospectively reviewed. Those with peritoneal tears managed using bipolar energy devices and at least 1 year of follow-up were included in the PT group, while patients treated with alternative closure methods were excluded. Demographic, operative, and postoperative data were retrieved from a prospectively maintained database and compared with those of patients without PTs. RESULTS: Among the 571 patients, the PT group (n=86) and the No-PT group (n=485), no significant demographic differences were found. The PT group had longer operative times (50 vs. 45 min, P<0.01), more bilateral repairs (39.5% vs. 28.5%, P=0.04), and higher lateral hernia rates (64% vs. 44.5%, P<0.01). In the PT group, 7 patients (8.1%) required Veres needle decompression, with no conversions to other approaches. Postoperative outcomes showed no significant differences in recurrence, seroma, or hematoma, with a median follow-up of 36 months for both groups. CONCLUSION: Sealing peritoneal tears with bipolar energy devices during TEP hernia repair is an effective and efficient technique, offering favorable long-term clinical outcomes without the need for additional instruments or conversion to other surgical approaches.