title: Preperitoneal prosthetic herniorrhaphy. One surgeon's successful technique.
abstract: OBJECTIVE
  To review the senior author's experience with preperitoneal mesh inguinal herniorrhaphy, evaluate the recurrence rate, and compare it with previously published data and with the developing technique of laparoscopic herniorrhaphy.
  
  
  METHODS
  A retrospective records review of 204 herniorrhaphies, follow-up of patients (mean follow-up, 3.5 years), and review of the literature.
  
  
  METHODS
  One general surgeon's clinical practice in an 860-bed regional referral hospital.
  
  
  METHODS
  One hundred sixty-two men and 13 women (mean age, 63 years) who underwent preperitoneal prosthetic herniorrhaphy by the senior author between 1984 and 1991 and whose medical records were available for review (175 [96%] of 183 patients).
  
  
  METHODS
  Short- and long-term postoperative complications and hernia recurrence.
  
  
  RESULTS
  One hundred fifty-two primary and 52 recurrent inguinal hernias were repaired using a preperitoneal prosthetic approach and either general or regional anesthesia. Wound complications occurred in 12 (5.9%) of 204 operations, and one recurrence (0.5%) was detected over the mean long-term follow-up period of 42 months (range, 7.9 to 110 months). A 25-year recurrence rate of 1% was predicted.
  
  
  CONCLUSIONS
  This repair compares favorably with similar, previously reported repairs and is suggested as a standard for comparison with the developing technique of laparoscopic herniorrhaphy.
authors.affiliation: Swedish Hospital Medical Center, Seattle, Wash.
authors.forename: H C
authors.initials: HC
authors.lastname: Hoffman
authors.forename: A L
authors.initials: AL
authors.lastname: Traverso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh; D013514:Surgical Procedures, Operative / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome