Totally laparoscopic extraperitoneal herniorrhaphy: a report of 142 cases

Objective To study the successful experience, operation skills, the safety, the feasibility and practicality of totally laparoscopic extraperitoneal herniorrhaphy (TEP).Methods Between October 2002 and May 2006,142 patients were performed 169 totally laparoscopic extraperitoneal hernia repairs for inguinal hernia,including 40 direct inguinal hernia and 129 indirect inguinal hernia operations.Among 142 patients,115 patients had unilateral hernia and 27 patients had bilateral hernias,including 29 recurrent hernia.Results Among 169 TEP,3 cases were converted from TEP to transabdominal preperitoneal hernia repair(TAPP). The operations were lasted for 30 to 182 minutes.The mean operating duration was 69 minutes for unilateral hernia and 106 minutes for bilateral hernia.The patients stayed in hospital for 5 to 12 days.The mean inpatient hospital stay was 7 days.The patients didn’t need analgesics.The mostly complications were scrotum hematomas or seromas,which appeared in 18 cases (10.65%).Inguinal pain appeared in 4 cases.One case had bladder injury.All the patients were followed up for 3-44 months.There was only 1 case of recurrence and it occurred in the initial part of the series.Conclusion The procedure of TEP is safe,with faster postoperative recover, less pain and lower recurrence rate.TEP should be the main laparoscopic procedure for inguinal hernia repair.