LAPAROSCOPIC HERNIOPLASTY - WHY DOES IT WORK

Background: To understand how laparoscopic hernioplasty prevents early recurrence of hernia, we reviewed our first 1,000 patients, We analyz ed the patients by age, sex, and hernia type and by whether their hern ia was primary or recurrent. Methods: The 1,000 patients had 1,336 her nias repaired by the transabdominal preperitoneal or the totally extra peritoneal approach. One thousand one hundred seventy-three hernias we re primary and 163 were recurrent. The type of hernia found varied wit h thp patient's age (p < 0.001), and with whether the hernia was prima ry or recurrent (p < 0.001); 14% of primary and 27% of recurrent herni as were complex, a surprisingly high incidence compared to historical controls, Results: With a median follow-up of 2 years, five hernias ha ve recurred and all were due to technical errors. Conclusions: The lap aroscopic repair's success may partially be due to its unique ability to diagnose previously overlooked complex elements. The defects are re paired without creating tension and the groin is reinforced with mesh, eliminating inherent weakness.