LAPAROSCOPIC HERNIA REPAIR - A PROSPECTIVE-STUDY OF 409 CASES

Inguinal hernia is a common operation which until recently has required a groin incision with the attendant morbidity and discomfort. A transabdominal pre-peritoneal mesh repair of inguinal hernias was prospectively studied with the aim of minimizing wound problems whilst achieving recurrence rates comparable to open techniques utilizing mesh repair. A total of 359 patients with 409 hernias (309 unilateral, 50 bilateral) including 41 recurrent hernias were repaired. Ages ranged from 17 to 83 years (median 54). Thirteen per cent were aged 70 years or older. A total of 337 patients (94%) were discharged from hospital within 24 h. Fifty-four patients (15%) had complications, mostly minor. These included fluid collections [23], spontaneously resolving pain in the testicle [9] and the pubic tubercle [5], and meralgia para-esthetica [6]. Major complications occurred in seven patients (1.9%): urinary retention in five (two requiring prostatectomy and another a small bowel obstruction), one small bowel obstruction from a port site hernia and a single mesh infection. There was no complication from laparoscopy. Convalescent time is short with a median return to normal activities of 3 days (range 0-30) and median return to work of 12 days (range 2-95). Three recurrences have been noted at a maximum 13 months (median 7) follow-up. We conclude that the laparascopic technique described is acceptable for the repair of inguinal hernias.