[Laparoscopic hernioplasty by total extraperitoneal approach].
BACKGROUND
Despite the increasing acceptance of the TEP-procedure by patients and general practitioners this method has to be further examined. In addition to the classic surgical criteria of examination, subjective aspects of patient comfort must be taken into consideration as they are getting more and more significant for the evaluation of different methods.


METHODS
According to this targets patients were clinically examined and questioned about specific topics regarding their quality of life after TEP-surgery and evaluated prospectively.


RESULTS
Between 1995 and 2000 endoscopic total extraperitoneal hernioplasty (TEP) was used for 200 inguinal hernia repairs in 195 patients. 195 patients could be interviewed about the operation's outcome and examined physically and sonographically after 3 months, 188 patients after 6 months and 184 patients after 12 months post-op. The recurrence rate was 1.7 %, the rate of major complications was < 1 %. Sensitivity disorders were found in 7.3 % of all cases at the final examination prior to discharging but none at the 3 months check-up. The median postoperative period until the resumption of sexual intimacy was approximately two weeks, but one male patient reported about long-lasting pain in copulation (0.51 %).


CONCLUSIONS
With regard to the aspects mentioned above, the TEP-procedure provided excellent results in the examined patient cohort and therefore turned out to be at least comparable with competitive endoscopic methods. A remarkable new finding was that patients could go back to work on average 2 weeks earlier than regaining their everyday fitness.
Alter
B
B
Chirurgische Abteilung, St. Anna Hospital Herne, Ausbildungsklinik der privaten Universität Witten/Herdecke. alter@annahospital.de
Kuhlmann
H-W
HW
Waleczek
H
H
Kozianka
J
J
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D019736:Prostheses and Implants; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D014938:Work Capacity Evaluation
D011138:Polytetrafluoroethylene