Background: Between October 1992 and May 1996, 893 hernia repairs were perf
ormed at the Surgical Clinic in Mannheim: 448 (50%) using laparoscopy (TAPP
-method) and 445 (50%) using the conventional anterior approach (Shouldice)
.
Materials and methods: For this study, 723 (81%) of these repairs were foll
owed up in a prospective trial of postoperative nerve irritations.
Results: The rate of nerve entrapment in the laparoscopic group was 4.2% (n
= 19), and in the group that underwent conventional surgery 1.8% (n = 8).
The genitofemoral nerve was affected with particularly high frequency (2%),
and the ilioinguinal nerve and lateral cutaneous nerve of the thigh (LCNT)
each was affected in 1.1% of the cases.
Conclusions: Reduction in the number of clips used and careful attention to
the anatomic nerve course during preparation and placement of mesh led to
a significant reduction in the occurrence of nerve irritations. In the last
100 patients who underwent laparoscopic hernia repair, only one nerve lesi
on was seen.