COMPLICATIONS AND RECURRENCES ASSOCIATED WITH LAPAROSCOPIC REPAIR OF GROIN HERNIAS - A MULTIINSTITUTIONAL RETROSPECTIVE ANALYSIS

Although the laparoscopic technique is a new approach to groin hernia, it is becoming more widely accepted as an alternative to traditional open techniques. This study is a preliminary review of complications a nd recurrences. A questionnaire specific for complications was sent to each investigator. From 12/89 to 4/93, 1,514 hernias were repaired; 1 19 (7.8%) were bilateral and 192 (12.7%) recurrent. There were 860 ind irect, 560 direct, 43 pantaloon, 37 femoral, and 6 obturator hernias, and 8 were not specified; 553 were repaired using a trans-abdominal pr eperitoneal mesh technique (TAPP), 457 with a total extraperitoneal te chnique (TEP), 320 with intraperitoneal onlay mesh (IPOM), 102 by ring closure, and 82 involved plug and patch technique. Eighteen intraoper ative and 188 postoperative complications were seen. The total complic ation rate was 13.6%, of which 1.2% were intraoperative. Of the intrao perative complications, 12 were related to the laparoscopic technique, three were related to the hernia repair, and one was related to anest hesia. The rate of conversion to open was 0.8%. Of the postoperative c omplications, there were 95 local, 25 neurologic, 23 testicular, 23 ur inary, 10 mesh, and 12 miscellaneous. There were 34 recurrences after the 1,514 hernia repairs (2.2%). The follow-up was reported in 828 pat ients for an average of 13 months. The recurrence rate varied drastica lly with the technique: A 22% recurrence rate after the plug and patch vs 3%, 2.2%, 0.7%, and 0.4% with the ring closure, IPOM, TAPP, and TE P, respectively. Laparoscopic repair of groin hernia can be safely per formed. Complications, mostly minor, diminish with experience. The rec urrence rate is less with large mesh which is anchored.