Laparoscopic treatment of inguinal hernias : prospective evaluation of 757 cases treated by a totally extraperitoneal route

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 4; no. 2; pp. 81 - 84
• Main Authors: OCCELLI, G, BARRAT, C, CATHELINE, J.-M, VOREUX, J.-P, CUETO-ROZON, R, CHAMPAULT, G
• Format: Journal Article
• Language: English
• Published: Paris Springer 01.06.2000; Springer Nature B.V
• Subjects: Abdomen; Abdominal wall; Anesthesia; Biological and medical sciences; Hernias; Laparoscopy; Medical sciences; Morbidity; Patients; Polypropylene; Prostheses; Prosthetics; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Hernia; Human; Endoscopic surgery; Prosthesis; Abdominal disease; Cohort study; Laparoscopy; Inguinal; Technique; Surgical closure
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/BF02353749

SummaryThe aim was to assess the value of treament of inguinal hernias by a totally extraperitoneal laparoscopic route. Between January 1993 and December 1998, 541 patients (490 men, 51 women) with 757 hernias were operated laparoscopically by a totally extraperitoneal route. Whenever the parietal repair required the insertion of a prosthesis, this was the method chosen. The procedure was perfomed under general anesthesia. One or two polypropylene prostheses of 15 × 12 cm were placed at the deep aspect of the abdominal wall, split but not fixed. The patients were followed up at one, six and twelve months and then annually. The mean operation time decreased with experience, from 66 minutes in 1993 to 47 minutes in 1998 for unilateral hernias and from 104 to 71.5 minutes for bilateral cases. The laparotomy conversion rate was 2%. Mortality was nil. Morbidity was as follows: hemorrhagic scrotal extravasations 10%, serous effusions 3.5%, phebitis 0.3%, pneumopathies 0.3%. The mean period of hospitalization was 2.9 days and the global recurrence rate was 0.6% (4 cases in the first year, 1 case at three years). The totally extraperitoneal laparoscopic route seems to be the method of choice for the treatment of inguinal hernias requiring a prosthesis. It reduces hospital stay and allows earlier return to work and is associated with only minor morbidity and a low recurrence rate.