LAPAROSCOPIC HERNIORRHAPHY - RESULTS AND TECHNICAL ASPECTS IN 450 CONSECUTIVE PROCEDURES

Background. The effectiveness of laparoscopic herniorrhaphy, the patie nt outcome, and technical aspects have been controversial. We have per formed 50 consecutive laparoscopic inguinal herniorrhaphies and have r eviewed the rationale, technical aspects, and the outcomes. Methods. F our hundred and fifty consecutive laparoscopic herniorrhaphies were pe rformed using synthetic mesh for tensionless repair and adhering to su rgical principles of preperitoneal herniorrhaphy. Patients were 16 to 83 years of age, 74% men, 26% women. Mesh was transfixed to anatomic l andmarks with suture or staples. The peritoneum was closed, separating mesh from abdominal contents.Results. Ninety percent of patients were discharged from perioperative care; 10% were in the hospital 23 hours as a result of urinary retention, cardiac disease, etc. No adhesive o r mesh complications occurred. Three hernias recurred at 2 to 4 months after operation. Two were repaired laparoscopically. Conclusions. Lap aroscopic inguinal herniorrhaphy is a safe and effective procedure. It compares favorably with other classic methods of hernia repair (espec ially use of a tensionless repair with mesh). Patients exhibit minimum morbidity and ambulate soon with minimal discomfort. This repair shou ld be considered preferential in many subsets of patients.