INTRAOPERATIVE EVENTS COMMON TO VIDEOSCOPIC PREPERITONEAL MESH INGUINAL HERNIORRHAPHY

BACKGROUND: Videoscopic preperitoneal mesh (VPM) inguinal herniorrhaph y avoids the entry into the abdominal cavity, which is necessary with other videoscopic techniques, Despite this advantage, surgeons have be en slow to adopt this technique. We reviewed our experience with VPM i nguinal herniorrhaphy, specifically investigating the technical aspect s of this approach, METHODS: Data were collected prospectively, Operat ive notes were reviewed retrospectively detailing intraoperative event s not ''typical'' with the VPM technique, RESULTS: One hundred consecu tive patients undergoing VPM repair of 127 hernias were studied, The r epair was completed in all but 2 patients, Mean operating time was 120 minutes (60 to 146), In 36 repairs there were 59 intraoperative ''eve nts'' requiring specific maneuvers to correct, Events identified were the need for transection of. the hernia sac, creation and repair of a peritoneal tear, and need to divide the inferior epigastric vessels, N o complications related to these events occurred, When events occurred , operative times were significantly longer (146 +/- 45 versus 83 +/- 23 minutes; P < 0.05), CONCLUSION: Intraoperative events are common wi th VPM herniorrhaphy. These events significantly prolong operating tim e, A surgeon's lack of familiarity with such events and how to deal wi th them may in part explain the reluctance to widely apply the VPM tec hnique. (C) 1997 by Excerpta Medica, Inc.