Transabdominal preperitoneal herniorraphy: technique and results.
As enthusiasm for laparoscopic surgery has grown, laparoscopic approaches to the groin hernia have evolved. The most widely accepted laparoscopic repair employs the placement of a large sheet of mesh in a preperitoneal position to cover potential hernia spaces. Between March 1994 and February 1997 160 inguinal and 3 femoral hernia were operated of an transabdominal preperitoneal (TAPP) polipropylen mesh. 131 patients were operated (128 males and 3 females, ranging in age from 19 to 82 years), 31 (23%) of them had bilateral hernias. Recurrent hernia was the indication in 52 (32%) cases. Average operating time for unilateral repair was 80 minutes and for bilateral repairs was 108 minutes. Postoperative complications included 7 (4.3%) cases of transient neuralgias, 20 (12%) cord/scrotal transient seromas-hematomas and 2 (1.2%) hydrocele. The 5 (3.1%) early recurrences were considered to be caused by technical inexperience and/or too small prosthetic patch. The laparoscopic hernioplasty has definitive advantage: minimal postoperative pain, short hospital stay (average postoperative time of hospitalization 3.1 days) and early restoration of full physical activity (in 1 to 2 weeks). The method should be considered as a potential "best option" in patients with recurrences and bilateral inguinofemoral hernias.
Bátorfi
J
J
General Surgical Department, County Legal City Hospital of Nagykanizsa, Hungary.
Kelemen
O
O
Vizsy
L
L
Simon
E
E
Bálint
A
A
Pósfai
G
G
D000005:Abdomen / Q000601:surgery; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005122:Exudates and Transudates; D005260:Female; D006406:Hematoma / Q000209:etiology; D006550:Hernia, Femoral / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery*; D006760:Hospitalization; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology; D010149:Postoperative Pain / Q000517:prevention & control; D010537:Peritoneum / Q000601:surgery; D011126:Polypropylenes; D012008:Recurrence; D012086:Reoperation; D012611:Scrotum / Q000473:pathology; D013085:Spermatic Cord / Q000473:pathology; D013526:Surgical Mesh; D006848:Testicular Hydrocele / Q000209:etiology; D013997:Time Factors
D011126:Polypropylenes