TRANSINGUINAL PREPERITONEAL MESH PROSTHES IS (TIPP) FOR REPAIR OF INGUINAL-HERNIA UNDER LOCAL-ANESTHESIA

Between January 1994 and December 1995 inguinal and femoral hernias we re repaired in 689 adults. In 58 patients (4 primary hernias, 54 recur rent hernias, 1st-7th recurrence) a mesh prosthesis (Marlex) was impla nted in the preperitoneal space using an open inguinal approach (TIPP) . After intraoperative classification of the hernia, the indications f or TIPP were L/M/Mc and F III type hernias and a weak or destroyed tra nsverse fascia. The operative technique of TIPP is described in detail . Half of the procedures were done with the patient under local anesth esia, There were no intraoperative complications. Besides an increased number of seromas the postoperative course following TIPP was compara ble with that after Shouldice procedures performed in the same period. During a follow-up period of 3-24 months to date, no recurrence has b een observed. If intraoperative hernia classification is performed, TI PP is an appropriate technique for recurrence-prone inguinal and femor al hernias.