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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2000 August;13(4):191-6
Laparoscopic repair of inguinal hernia. Personal experience and literature review
Pisani Ceretti A., Sacchi E., Pozzi G., Magni C., Confalonieri M., Crema G.
The laparoscopic surgery of inguinal hernia provides three main kinds of technique: IPOM (intraperitoneal onlay mesh), LEP (laparoscopic extraperitoneal prosthesis) and TAPP (transabdominal approach with preperitoneal prosthesis). TAPP and LEP are the two methods which have given the best results until now.
From September 1997 to June 1999 we performed 72 laparoscopic hernia repairs with the TAPP technique in 43 patients (41 men and 2 women). The mean age was 57.3 years (range 29-76 years). Of the 72 hernias, 29 were bilateral and 13 were recurrent. There were 45 indirect hernias (62.5%), 25 direct hernias (34.7%) and 2 femoral hernias (2.8%). All procedures were performed under general anesthesia, placing 8x13 cm prolene mesh, fixed along its upper border and on the Cooper's ligament. Mean operation time was 80 minutes for monolateral hernias and 140 minutes for bilateral hernias. Two patients required conversion to open surgery. Postoperative complications were three, two minor (inguinal neuralgia) and one major (scrotal hematoma). Patients were discharged 3.4 days after the operation. Three hernia recurrences were observed at the beginning of our experience: everyone occurred within 1 month after operation, because of technical mistakes. Median follow-up was of 9.1 months (range 1-21 months).
We think that the TAPP can treat all kinds of inguinal hernia and that it is particularly indicated in cases of bilaterality, recurrence and association with another pathology treatable by laparoscopic approach.