LAPAROSCOPIC TREATMENT OF RECURRENT HERNI A AFTER PROSTHETIC HERNIORRAPHY - VALUE OF AN INTRAPERITONEAL TECHNIQUE WITH EPTFE PATCH

From April 1993 to December 1994, 14 failures of classic prosthetic he rniorraphies in 13 patients (13 men) were treated by a laparoscopic in traperitoneal onlay mesh technique (IPOM) using an ePTFE patch. The me an age of these patients was 55.69 +/- 13.11 years (28 to 70). The mea n operating time was 72.5 +/- 24 mn (40 to 120). The technique could n ot be performed in one case. The mean postoperative pain at D1, evalua ted by a visual analog scale graduated from 0 to 10 was 2.36 (2 to 3). The mean hospital stay was 1.64 days (1 to 3). One inguinal hematoma occurred and resolved after a short incision. The mean time to return to work or normal activity was 12.14 +/- 7.25 days (3 to 30). All pati ents were reviewed. The mean follow-up was 13.37 +/- 2.87 months (6 to 25). No testicular atrophy was observed. One recurrence occurred at M 6 treated at M9 by an open procedure. Our study suggests that this tec hnique, avoiding extensive preperitoneal dissection, thus decreasing v ascular and genital risks, would be useful in the treatment of failure s of prosthetic herniorraphies.