Laparoscopic herniorrhaphy: results and technical aspects in 450 consecutive procedures.

BACKGROUND

The effectiveness of laparoscopic herniorrhaphy, the patient outcome, and technical aspects have been controversial. We have performed 450 consecutive laparoscopic inguinal herniorrhaphies and have reviewed the rationale, technical aspects, and the outcomes.

METHODS

Four hundred and fifty consecutive laparoscopic herniorrhaphies were performed using synthetic mesh for tensionless repair and adhering to surgical principles of preperitoneal herniorrhaphy. Patients were 16 to 83 years of age, 74% men, 26% women. Mesh was transfixed to anatomic landmarks with suture or staples. The peritoneum was closed, separating mesh from abdominal contents.

RESULTS

Ninety percent of patients were discharged from perioperative care; 10% were in the hospital 23 hours as a result of urinary retention, cardiac disease, etc. No adhesive or mesh complications occurred. Three hernias recurred at 2 to 4 months after operation. Two were repaired laparoscopically.

CONCLUSIONS

Laparoscopic inguinal herniorrhaphy is a safe and effective procedure. It compares favorably with other classic methods of hernia repair (especially use of a tensionless repair with mesh). Patients exhibit minimum morbidity and ambulate soon with minimal discomfort. This repair should be considered preferential in many subsets of patients.