Totally preperitoneal endoscopic inguinal hernia repair.

BACKGROUND

Recurrence rate after conventional inguinal hernia repair is high. However, the Stoppa technique has provided the best results. The totally preperitoneal endoscopic inguinal hernia repair is developed in order to combine the results of the Stoppa technique with the advantages of minimally invasive surgery.

METHODS

Between October 1992 and August 1994, 403 patients with a total of 632 inguinal hernias, including 82 recurrences, were treated by totally preperitoneal endoscopic inguinal hernia repair with mesh placement of at least 10 x 15 cm.

RESULTS

Mean(s.e.m.) operating time was 42(1.2) min for unilateral and 58(1.0) min for bilateral hernia repair. Mean(s.e.m.) postoperative hospital stay was 2(0.04) days. Complication rates during and after operation were 0.3 and 3.3 per cent respectively. The morbidity rate at 1 month after operation was 3.5 per cent. The recurrence rate was 0.3 per cent at 1-year follow-up.

CONCLUSION

Totally preperitoneal endoscopic inguinal hernia repair is safe and reproducible for any type of primary or recurrent inguinal hernia, even in patients with previous subumbilical surgery or severe systemic disease. Careful follow-up is mandatory to assess the late recurrence rate.