Laparoscopic repair of strangulated hernias.
BACKGROUND
Although laparoscopic transabdominal preperitoneal polypropylene (TAPP) hernia repair is now a recognized procedure for groin hernia repair in patients undergoing elective surgery, there is a scarcity of data on TAPP repair in emergency situations such as those involving strangulated hernias.


METHODS
Unless contraindicated, the authors' department considers laparoscopic TAPP repair the procedure of choice for all strangulated hernias. A prospective database of 1,532 consecutive hernia repairs performed between May 1998 and April 2004 was reviewed.


RESULTS
A total of 28 irreducible strangulated hernias were observed and repaired through laparoscopic TAPP. There were three conversions (10.7%): one because of extensive adhesions and two because of bowel distention. Resection became necessary in 9 (36%) of the 25 cases involving effective TAPP repair of strangulated hernias. The mean operation time, with and without resection, was 103 and 55 min, respectively. The rate of postoperative morbidity was 4% because of one inguinal hematoma case. During a mean follow-up period of 340 days, there were no recurrences after TAPP repair.


CONCLUSIONS
For selected patients, the TAPP approach appears to be a good therapeutic option for strangulated hernias.
Rebuffat
C
C
Department of General Surgery, University of Milan, Via F. Sforza 35, 20122 Milan, Italy. carlo.rebuffat@unimi.it
Galli
A
A
Scalambra
M S
MS
Balsamo
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome
D011126:Polypropylenes