LAPAROSCOPIC HERNIA REPAIR - A RURAL PERSPECTIVE

Laparoscopic hernia repair has been used successfully to repair inguin al as well as some ventral, incisional, and umbilical hernias. The lap aroscopic approach is favored by patients because they experience litt le, if any, postoperative pain and enjoy a rapid return to unrestricte d activity. We repaired 84 hernias in 61 patients from March 1991 to D ecember 1992. All patients were treated by the author in rural west-ce ntral Minnesota hospitals, each of which has 30 beds or less. A unique preperitoneal patch design was used, and a novel technique for the di ssection of an indirect hernia sac was developed. The patient populati on treated was older than that reported in other series, with an avera ge age of 55 and a median age of 61 years. Based on postoperative inte rviews, 95% of the patients reported being satisfied with the procedur e and their outcome. All ten patients who had also experienced traditi onal hernia surgery preferred the laparoscopic repair. They cited less post-operative pain and a quicker return to full activity as the main reasons for their preference. Of the three patients who had a recurre nce of their hernia, two have had a repeat laparoscopic hernioplasty w ithout subsequent recurrence. The third patient has indicated that he plans to have his recurrent hernia repaired laparoscopically again. On e hundred percent of the patients indicated that they would choose to have a laparoscopic hernia repair should they need another hernia repa ired in the future.