alexa Totally Extraperitoneal Herniorrhaphy (TEP) after Ipsil
ISSN: 2165-7920

Journal of Clinical Case Reports
Open Access

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Case Report

Totally Extraperitoneal Herniorrhaphy (TEP) after Ipsilateral Spermatic Vein Embolization: A Case Report

Diedert Luc De Paep1*, Vincent De Coninck2, Nele Van De Winkel1 and Dirk Michielsen2

1Department of Surgery, University Hospital of Brussels, Belgium

2Department of Urology, University Hospital of Brussels, Belgium

*Corresponding Author:
Diedert Luc De Paep
Department of Surgery
University Hospital of Brussels, Belgium
Tel: 0032 475 28 75 19
Fax: 0032 24 77 86 89
E-mail: [email protected]

Received March 08, 2016; Accepted May 09, 2016; Published May 17, 2016

Citation: De Paep DL, De Coninck V, Van De Winkel N, Michielsen D (2016) Totally Extraperitoneal Herniorrhaphy (TEP) after Ipsilateral Spermatic Vein Embolization: A Case Report. J Clin Case Rep 6:785. doi:10.4172/2165-7920.1000785

Copyright: © 2016 De Paep DL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Introduction: Both totally extraperitoneal herniorrhaphy (TEP) and spermatic vein embolization are minimal invasive techniques gaining in popularity in the treatment of inguinal hernia and varicocele respectively. A previous spermatic vein embolization makes a TEP more difficult because of fibrotic changes of the spermatic vein. This is to our knowledge the first case report describing these difficulties and changes after spermatic vein embolization. Case Presentation: We report the case of a 37 year old male who presented with an uncomplicated left sided inguinal hernia and ipsilateral varicocele. He first underwent a percutaneous left spermatic vein embolization for a grade 3 varicocele and later a TEP for the inguinal hernia. Reduction of the peritoneum and proper mesh placement were complicated due to fibrotic changes of the spermatic vein. Due to the dissection and resection of the embolized spermatic vein there was minor blood loss, increased operating room time and postoperative pain was more then average. Conclusions: In case of a concomitant inguinal hernia and ipsilateral varicocele requiring embolization we propose to treat these diseases concomitantly or first treat the inguinal hernia and embolising the varicocele after repair of the hernia.


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