Laparoscopic inguinal hernia repair. A review of 2500 cases

A prospective study was performed to evaluate the safety and efficiency of laparoscopic hernia repair in our hospital. Since 1992 2500 consecutive lap aroscopic transabdominal hernia repairs (TAPP) were performed in 1952 patie nts. There were 548 bilateral (22%) and 431 recurrent hernias (17,3%). Aver age age was 59 years. We used a:mesh of 12x15cm. Operating time varied between 11 and 109 minutes with an average of 32 minu tes. We had a recurrence rate in our population of 1,04%. There were 89 com plications (3,56%). We saw three bladder injuries, one of them needed conve rsion to open laparotomy. Three of 38 haematomas required open exploration. Three patients were reoperated because of nerve irritation and incriminate d clips were removed with good postoperative result. An incarcerated trocar hernia occurred in 6 cases. There was one wound infection at the umbilical incision. No infection or incompatibility reaction at the mesh was observe d. There was a significant decline over time in our complication rate. Init ially we found 27 complications in the group of the first 200 cases (13,5%) , the corresponding rate at present is 2%. At the same time the rate of rec urrence decreased with growing experience in laparoscopic hernia repair. Laparoscopic hernia repair can safely be performed, the rates of recurrence s and complications are low. Our experience with this technique shows good results combined with the benefits of minimal invasive procedures. In our c linic it is the method of choice in all age groups.