Laparoscopic groin hernia surgery: the TAPP procedure. Transabdominal preperitoneal hernia repair.

OBJECTIVE

To describe the technique and results of laparoscopic transabdominal preperitoneal (TAPP) hernia repair.

DESIGN

A case series, with a detailed description of the operative technique.

SETTING

A university affiliated hospital.

PATIENTS

A consecutive series of 554 patients (494 male, 60 female) who underwent laparoscopic hernia repair in a single institution. The mean follow-up was 14 months.

INTERVENTIONS

Laparoscopic TAPP hernia repair was performed in almost all patients. Simple closure was performed in a patient with a strangulated hernia, and a mesh-based repair was used in a patient with bilateral obturator hernias.

MAIN OUTCOME MEASURES

Complications and recurrence.

RESULTS

The laparoscopic TAPP repair was successful in 550 of the 554 patients who underwent 632 hernia repairs. conversion was necessary in 4 patients. Complications were infrequent and there were no recurrences. Only 3.4% of patients were lost to follow-up. The most frequent complications were urinary retention (27) and hematoma and seroma (38) in the early postoperative period. Neuralgia (11) and hydrocele (10) also occurred. Mesh infection occurred in only 1 patient and port-site hernias in 3 patients. there was 1 death from an acute myocardial infarction.

CONCLUSION

Laparoscopic TAPP hernia repair is associated with an exceedingly low recurrence rate and an acceptable complication rate.