Hernia repair can be performed safely and expeditiously during radical pelvic surgery using the preperitoneal approach through a median longitudinal incision. We performed 41 preperitoneal herniorrhaphies simultaneously with 343 radical retropubic prostatectomies and 26 radical cystoprostatectomies. There is no evidence of recurrent hernias to date and no complications attributable to the hernia repairs. We present the technique and illustrate the preperitoneal anatomy, which allows the safe, efficacious performance of these procedures.
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