Prospective audit of laparoscopic totally extraperitoneal inguinal hernia repair - A multicenter study of the Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTC)

Background: This article reports the results of a multicenter prospective a udit of totally extraperitoneal (TEP) inguinal hernia repair conducted by t he Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTC) fro m May 1995 to August 1996. Methods: At 29 Swiss centers 1,605 inguinal hernia repairs were performed i n 1,186 patients. Half of the repairs were performed by operators whose exp erience consisted of fewer than 51 procedures, Patients were followed up fo r 1 year. Results: Bilateral repairs were performed in 35% of the patients, and 15% o f all repairs were for recurrent hernia. Conversion rates to the transabdom inal preperitoneal (TAPP) technique and open surgery were 1.8% and 1.6%, re spectively. Main postoperative complications were hematoma and urinary rete ntion. At 3 months, seroma was more frequent with slit prosthesis. The recu rrence rate was 0.6% at 3 months and 1.6% at 1 year, not depending on the t ype of implant. The rate for recurrent hernias did not differ from that for primary repairs. Conclusions: Total extraperitoneal (TEP) repair can be performed with low m orbidity and a high level of patient satisfaction. The effects of the learn ing curve are not to be neglected. The 1-year recurrence rate is 1.6%. Publ ished data on TEP suggest that late recurrences may be less frequent than a fter open repair.