Totally laparoscpic extraperitoneal herniorrhaphy:a report of 260 cases

Objective To study and summarize the successful experience, the safety, the feasibility, the practicality and operation skills of totally laproscopic extraperitioneal herniorrhaphy ( TEP ). Methods Between September 2008 and March 2012,260 patients were performend (292 totally laparoscopic extraperitoneal hernia repars for inguinal hernia ). Including 50 direct inguinal hernia, 232 indirect inguinal hernia and 10 complex inguinal hernia operations. Among 260 patients, 240 patients had unilateral hernia and 20 patients had bilateral hernias, including 16 recurrent hernia. Results The operation were lasted for 45 to 190 minutes (the mean operating duration was 50 minutes for unilateral hernia and 120 minutes for bilateral hernia). There were 10 patients need analgesics. The patients stayed in hospital for 2 to 9 days, the mean inpatient hospital stay was (3.0 ± 1.6)days. The mostly complications were scrotum bematomas or seromas, which appeared in 20 cases. Urinary retention appeared in 18 cases. Bladder injury appeared 3 case. Inguinal pain appeared in 8 case. All the patients were followed up for 2-40 months. There was only 3 case of recurrence, which was early case. Conclusions The procedure of TEP is safe, with faster postoperative recover, less pain, lower incidence of pain, better comfort quality and lower recurrence rate. TEP should be the main laparoscopic procedure for inguinal hernia repair.