C J Ingoldby1. 1. Department of Surgery, Pinderfields Hospital, Wakefield UK.
Abstract
BACKGROUND: Musculotendinous groin disruption is common in professional sportsmen. Diagnosis is difficult and management complicated by strong desires for early return to sporting activity. The possible role of laparoscopic repair in promoting early recovery was examined. METHODS: A series of patients with persistent pain that prevented sport for more than 3 months were treated surgically. Thirty repairs were performed on 28 players, 18 professional and nine amateur. Seventeen injuries were sustained playing rugby league, seven association football and four other sports. There were 14 conventional repairs (11 Lichtenstein) and 14 laparoscopic (two bilateral). All patients were discharged within 24 h. RESULTS: No player complained of severe postoperative pain. Seven of 14 patients who had laparoscopic repair denied experiencing any pain at all. Training was resumed within 4 weeks for nine of 14 patients who had a conventional repair and 13 of 14 who underwent laparoscopic repair. Full contact training restarted at a median 5 (range 1-6) weeks for conventional and 3 (range 1-9) weeks for laparoscopic repair (P < 0.05). Two players had persistent neuralgia after laparoscopic repair which settled by 2 months. One player had recurrent pain 5 months after laparoscopic repair, and one had a recurrent hernia 22 months after conventional repair. There were no wound problems. CONCLUSION: Laparoscopic repair appears as effective as conventional repair for sporting injuries, and merits further evaluation as a technique to permit early return to activity.
BACKGROUND: Musculotendinous groin disruption is common in professional sportsmen. Diagnosis is difficult and management complicated by strong desires for early return to sporting activity. The possible role of laparoscopic repair in promoting early recovery was examined. METHODS: A series of patients with persistent pain that prevented sport for more than 3 months were treated surgically. Thirty repairs were performed on 28 players, 18 professional and nine amateur. Seventeen injuries were sustained playing rugby league, seven association football and four other sports. There were 14 conventional repairs (11 Lichtenstein) and 14 laparoscopic (two bilateral). All patients were discharged within 24 h. RESULTS: No player complained of severe postoperative pain. Seven of 14 patients who had laparoscopic repair denied experiencing any pain at all. Training was resumed within 4 weeks for nine of 14 patients who had a conventional repair and 13 of 14 who underwent laparoscopic repair. Full contact training restarted at a median 5 (range 1-6) weeks for conventional and 3 (range 1-9) weeks for laparoscopic repair (P < 0.05). Two players had persistent neuralgia after laparoscopic repair which settled by 2 months. One player had recurrent pain 5 months after laparoscopic repair, and one had a recurrent hernia 22 months after conventional repair. There were no wound problems. CONCLUSION: Laparoscopic repair appears as effective as conventional repair for sporting injuries, and merits further evaluation as a technique to permit early return to activity.
Authors: Gerwin A Bernhardt; Gerald Gruber; Benjamin S Molderings; Herwig Cerwenka; Mathias Glehr; Christian Giessauf; Peter Kornprat; Andreas Leithner; Hans-Jörg Mischinger Journal: Surg Endosc Date: 2013-09-06 Impact factor: 4.584