Laparoscopic hernia repair - the facts, but no fashion

Background: For about 10 years now, laparoscopic hernia surgery has been in troduced as an additional mode of therapy in the treatment of inguinal hern ias. This method is being reproached with higher costs of surgery and rate of complications, as well as missing long-term results. Materials and metho ds: Within a literature research, data from 25 randomised trials and 16 pro spective observational studies on endoscopic and conventional hernia surger y were evaluated. Statistics were calculated using the chi(2) test. Results : Compared with the conventional suture technique and tension-free surgery, the endoscopic repair proved to be advantageous with regard to postoperati ve pain and period of disablement. There was no significant difference betw een the methods when evaluating the rate of complications. In two randomise d trials, there was a significant difference in favour of endoscopic repair with regard to the recurrence rates, whereas in the other studies a signif icant difference could not be shown. In the prospective series, recurrence rates were 0.71% for totally preperitoneal repair (TEP) and 1.06% for trans abdominal preperitoneal repair (TAPP) repair. Conclusion: Endoscopic hernia surgery (TAPP and TEP) represents an efficient method of treatment in the therapy of inguinal hernias. Recurrent and bilateral hernias can be seen as an absolute indication for endoscopic repair.