Original

J Minim Invasive Surg 2007; 10(2): 83-88

Published online December 30, 2007

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

복강경적 복막외접근 서혜부 탈장교정술: 3차 병원에서의 경험 105예

김재희ㆍ설지영

충남대학교 의과대학 외과학교실

Laparoscopic Totally Extraperitoneal Inguinal Herniorrhaphy: A Personal Experience at a Tertiary Care Center

Jae Hui Kim, M.D., Ji Young Sul, M.D., Ph.D.

Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Although laparoscopic inguinal herniorrhaphy was introduced several years ago, the use of laparoscopic repair remains controversial because of technical and anatomical complexities, and a longer surgical time. In this report, the effectiveness and advantages of laparoscopic herniorrhaphy are examined through a clinical review of patients that have undergone laparoscopic extraperitoneal inguinal hernia repair (TEP). Methods: Between January 2002 and July 2007, a retrospective case series of 105 patients that underwent laparoscopic TEP for an inguinal hernia by a single surgeon was evaluated. The patients underwent follow-up with a physical examination and telephone interview at a tertiary care center. Results: A total of 117 TEP procedures in 105 patients were successfully performed without conversion to transabdominal preperitoneal (TAPP) or open surgery. The age of the patients ranged from 15∼86 years, with a male to female ratio of 6:1. During surgery, there were no intraoperative complications. The mean postoperative hospital stay was 1.4 days (range, 1∼5 days). Postoperatively, six cases of urinary retention (5.7%), three cases of scrotal hydrocele (2.8%), one case of cord edema (0.9%), five cases of chronic inguinal discomfort or pain (4.7%), and one case of mesh infection (0.9%) were noted, but there was no significant major morbidity or mortality. Chronic groin discomfort occurred in five patients, which was not significant in four patients and mild in one patient. There were no recurrences in all of the patients during the follow-up period from 2 months to 66 months. Most of the patients were satisfied with their results. Conclusion: Laparoscopic TEP is a safe and effective procedure to repair inguinal hernias with minimal morbidity and may be chosen as a primary procedure in the near future.

Keywords Laparoscopic herniorraphy, Totally extraperitoneal approach, Inguinal hernia

Article

Original

J Minim Invasive Surg 2007; 10(2): 83-88

Published online December 30, 2007

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

복강경적 복막외접근 서혜부 탈장교정술: 3차 병원에서의 경험 105예

김재희ㆍ설지영

충남대학교 의과대학 외과학교실

Laparoscopic Totally Extraperitoneal Inguinal Herniorrhaphy: A Personal Experience at a Tertiary Care Center

Jae Hui Kim, M.D., Ji Young Sul, M.D., Ph.D.

Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Although laparoscopic inguinal herniorrhaphy was introduced several years ago, the use of laparoscopic repair remains controversial because of technical and anatomical complexities, and a longer surgical time. In this report, the effectiveness and advantages of laparoscopic herniorrhaphy are examined through a clinical review of patients that have undergone laparoscopic extraperitoneal inguinal hernia repair (TEP). Methods: Between January 2002 and July 2007, a retrospective case series of 105 patients that underwent laparoscopic TEP for an inguinal hernia by a single surgeon was evaluated. The patients underwent follow-up with a physical examination and telephone interview at a tertiary care center. Results: A total of 117 TEP procedures in 105 patients were successfully performed without conversion to transabdominal preperitoneal (TAPP) or open surgery. The age of the patients ranged from 15∼86 years, with a male to female ratio of 6:1. During surgery, there were no intraoperative complications. The mean postoperative hospital stay was 1.4 days (range, 1∼5 days). Postoperatively, six cases of urinary retention (5.7%), three cases of scrotal hydrocele (2.8%), one case of cord edema (0.9%), five cases of chronic inguinal discomfort or pain (4.7%), and one case of mesh infection (0.9%) were noted, but there was no significant major morbidity or mortality. Chronic groin discomfort occurred in five patients, which was not significant in four patients and mild in one patient. There were no recurrences in all of the patients during the follow-up period from 2 months to 66 months. Most of the patients were satisfied with their results. Conclusion: Laparoscopic TEP is a safe and effective procedure to repair inguinal hernias with minimal morbidity and may be chosen as a primary procedure in the near future.

Keywords: Laparoscopic herniorraphy, Totally extraperitoneal approach, Inguinal hernia

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