title: Results of a prospective multicenter trial evaluating the ePTFE peritoneal onlay laparoscopic inguinal hernioplasty.
abstract: A 2.8-year prospective multicenter trial was conducted to evaluate the ePTFE peritoneal onlay laparoscopic inguinal hernioplasty. A total of 441 inguinal hernias were repaired in 351 patients (326 male; 25 female). Two hundred twenty-six of the hernias were direct, 185 indirect, 4 femoral, 26 pantaloon, 90 bilateral, and 92 recurrent. Standardized data collection forms were used and submitted for centralized data analysis. For the hernioplasty, Cooper's ligament was exposed and an 8 cm x 12 cm x 1 mm GORE-TEX Soft Tissue Patch was stapled circumferentially to Cooper's ligament and the endoabdominal fascia. Patients were followed at 1 week, 6 months, 1 year, and then annually. Three-month intervals were used as needed. There was a mean follow-up of 447 days, with 21% of the total repairs followed for more than 2 years and 56% for more than a year. The overall follow-up rate was 95.5%. The operative and postoperative complication rates were 0.45% and 8%, respectively. There were 17 recurrent hernias (3.8%). The range of experience among the investigators was 13 to 168 hernioplasties. With the completion of 25 cases per investigator, the recurrence rate fell to 0.39%. Postoperative analgesia averaged a 24-hr supply of medication; 12.2% of patients required no analgesia. Convalescence averaged 5.4 days, and return to work averaged 7.7 days. This multicenter trial demonstrates that the ePTFE laparoscopic peritoneal onlay inguinal hernioplasty is a safe and dependable repair, especially after the initial learning curve is surmounted.
authors.affiliation: Community Medical Center, Scranton, Pennsylvania, USA.
authors.forename: F K
authors.initials: FK
authors.lastname: Toy
authors.forename: M
authors.initials: M
authors.lastname: Moskowitz
authors.forename: R T
authors.initials: RT
authors.lastname: Smoot
authors.forename: M
authors.initials: M
authors.lastname: Pleatman
authors.forename: A
authors.initials: A
authors.lastname: Bagdasarian
authors.forename: W
authors.initials: W
authors.lastname: Polito
authors.forename: S D
authors.initials: SD
authors.lastname: Carey
authors.forename: R
authors.initials: R
authors.lastname: Schatz
authors.forename: K
authors.initials: K
authors.lastname: Janes
authors.forename: M E
authors.initials: ME
authors.lastname: Zipser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications; D011446:Prospective Studies; D013526:Surgical Mesh
chemical_list: D011138:Polytetrafluoroethylene