TRANSABDOMINAL PREPERITONEAL LAPAROSCOPIC INGUINAL HERNIORRHAPHY - ASSESSMENT OF INITIAL EXPERIENCE

Objective: To evaluate our initial experience with laparoscopic inguin al herniorrhaphy. Design: We retrospectively studied a consecutive ser ies of patients selectively chosen for laparoscopic repair of inguinal hernia, Material and Methods: The study cohort consisted of 173 patie nts treated by a single surgeon between 1992 and 1995, For all operati ons, a transabdominal approach was used, Follow-up was obtained by tel ephone contact or letter. Results: The study group consisted of 167 ma le and 6 female patients with a mean age at operation of 55 years (ran ge, 15 to 81), During the study period, 206 laparoscopic inguinal hern ia repairs were performed in the 173 patients. Only one patient (0.6%) required conversion to laparotomy. Bilateral hernia repair was done i n 31 patients (18%). Of the 206 procedures, 63 repairs (31%) were perf ormed for recurrent hernias. In 69% of the patients, the procedure was completed on an outpatient basis, Early postoperative complications n ecessitating surgical intervention occurred in four patients, The medi an time to return to work or normal physical activity was 7 days for u nilateral and 12 days for bilateral hernia repair (P = 0.18), A mean f ollow-up of 29 months was obtained for 171 patients(99%). In sis patie nts (3%), a recurrent hernia developed. Four of these six patients had previously undergone an open surgical procedure on the side of the re currence. Conclusion: Laparoscopic inguinal herniorrhaphy is a feasibl e alternative to open hernia repair. This operation, however, should b e reserved for selected patients, Longer follow-up and controlled tria ls comparing laparoscopic and tension-free open herniorrhaphy are nece ssary for assessment of the relative benefits of this procedure.