Laparoscopic inguinal hernia repair: is the enthusiasm justified?
One surgeon repaired 72 inguinal hernias in 61 patients by a transabdominal preperitoneal laparoscopic placement of prosthetic mesh. There were 58 male and 3 female patients; the mean age was 47.9 years. Thirty-six unilateral inguinal hernias (either direct or indirect), 11 bilateral inguinal hernias, 12 recurrent inguinal hernias, and 2 unilateral pantaloon inguinal hernias were repaired. There were no operative mortalities. The mean follow-up was 21 months, with a range of 6 to 42 months. Ten hernia recurrences (13.8%) were documented 3 to 24 months postoperatively (mean, 12 months). There were six direct hernia recurrences, two indirect hernia recurrences, and two recurrences of recurrent hernia repairs. Thirteen patients (21.3%) experienced morbidity: seromas in eight, a hematoma in one, an ileus in one, hematuria in one, and neuropathy in two. In our opinion, the significant morbidity and early recurrence rate of a laparoscopic inguinal hernia repair are unacceptable. Enthusiasm for laparoscopic technique to repair inguinal hernias is not justified if similar morbidity and recurrence rates are documented within the surgical community.
Cooper
S S
SS
Department of Surgical Education, Greenville Hospital System, South Carolina 29605, USA.
McAlhany
J C
JC
D000328:Adult; D005260:Female; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies