The clinical experience of totally laparoscopic extraperitoneal herniorrhaphy (a report of 338 cases)

Objective To conclude clinical experience of totally laparoscopic extraperitoneal herniorrhaphy of 338 cases.Methods A retrospective study was carried out on 292 patients with inguinal hernia who were performed 338 totally laparoscopic extraperitoneal herniorrhaphy between October 2002 and May 2007.The clinical data of these patients was analyzed.292 patients who were 18-91 ages(the average age was 54)were performed 338 totally laparoscopic extraperitoneal herniorrhaphy,including 57 direct hernia and 281 indirect hernia operations.Among 292 patients,246 cases had unilateral hernia and 46 cases had bilateral hernia,including 42 recurrent hernia.Results The rate of successful operation was 98.23%.The operation lasted 25-220min.The average operating duration was 60min for unilateral hernia and 96min for bilateral hernia.The patients stayed in hospital for 4-16d without needing of analgesics.The average inpatient hospital stay was 7d.The mostly complications were scrotum hematoma or seroma,which appeared in 29 cases(9.93%),and the chronic inguinal pain after operation appeared in 4 cases(1.37%),one case had bladder injury.There was only 1 case of recurrence,1 case of surgical bleeding,no operative deaths.All the patients were followed up for 6-60months.Conclusion Laparoscopic totally extraperitoneal inguinal hernia repair surgery was safe,low recurrence rate.To master surgical skills could improve the success rate and reduce postoperative complications and recurrence rate.