Surgical treatment of sports hernia: Laparoscopic approach

Abstract

Sports hernia (SH) is a weakness of the posterior wall of the inguinal canal causing groin pain commonly seen in active sports persons. The prevalence in physically active adults is between 5 and 10 %. Sports hernia, in a wider perspective also named athletic pubalgia, has multiple etiological factors. Surgical approach includes various open techniques (with or without mesh) or laparoscopic transabdominal pre-peritoneal (TAPP) or total extraperitoneal (TEP) techniques with a mesh behind the injured groin. The results of operative treatment from single centers are reported to be good to excellent in between 70 and 90 % of patients. TEP and TAPP are minimally invasive techniques for the treatment of SH. Athletes recover quickly and return to sports early. There are few randomized controlled trials in this field with no single surgical technique exhibiting any significant advantage over the other. In this chapter, we review shortly the pathophysiology, diagnostic difficulties, and treatment using the laparoscopic/endoscopic approach of SH and the associated athletic pubalgia.