LAPAROSCOPIC HERNIORRHAPHY - TECHNICAL CONCERNS IN PREVENTION OF COMPLICATIONS AND EARLY RECURRENCE

Laparoscopic herniorrhaphy continues to gain popularity, but should be subjected to proper scrutiny before widespread acceptance. From 5/91 to 6/93, 290 transabdominal preperitoneal (TAPP) laparoscopic herniorr haphies were performed on 244 adult patients at Georgia Baptist Medica l Center. Procedures consisted of indirect (164), direct (73), femoral (5), obturator (7), and recurrent (41) hernia repairs, with a mean op erative time of 81.2 minutes (range 30-193 min). The overall technical complication rate was 5.3% and includes lateral thigh paresthesias (6 ), inferior epigastric artery injury (4), enterotomy during adhesiolys is (1), bowel obstruction secondary to herniation through a lateral tr ocar site (1), and bladder injury (1). The recurrence rate is 1% (3/29 0), with a mean follow up of 11 months (range 2-27 months). The author s present herein a discussion of technical considerations in an attemp t to help decrease complications and recurrence as others incorporate laparoscopic hernia repair into their surgical armamentarium.