title: Total extraperitoneal preperitoneal laparoscopic hernia repair using spinal anesthesia.
abstract: BACKGROUND
  Laparoscopic herniorrhaphy is a well-debated approach to inguinal hernia repair. Multiple technical and outcome variables have been compared with those of traditional open inguinal hernia repairs. One of these variables is the choice of anesthesia. To date, no reports describe the use of spinal anesthesia for laparoscopic hernia repairs. We present herein a review of our experience with spinal anesthesia for the total extraperitoneal preperitoneal laparoscopic hernia repair (TEP).
  
  
  METHODS
  We prospectively reviewed 30 patients undergoing TEP while under spinal anesthesia. Methods of anesthesia, surgical procedure, operative and anesthesia delivery times, as well as outcomes were reviewed. Patients were followed up over a 2-year period. Short- and long-term results of the surgical procedure and anesthesia delivered were noted.
  
  
  RESULTS
  All patients underwent successful laparoscopic hernia repair while under spinal anesthesia without conversion to general anesthesia. Forty-four hernias were repaired in 30 patients. Short- and long-term follow-up (2 years) revealed no significant untoward affects from the spinal anesthesia in this series of patients. Aside from inguinodynia in 3 patients in the short-term, no other short-term or long-term untoward sequelae occurred.
  
  
  CONCLUSIONS
  Spinal anesthesia is a feasible, and in our experience, the preferable method of anesthesia for total extraperitoneal laparoscopic hernia repair.
authors.affiliation: Department of Surgery, Greenwich Hospital, Yale New Haven Health System, Greenwich, Connecticut, USA. SSG06830@Hotmail.com
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Molinelli
authors.forename: Alfonso
authors.initials: A
authors.lastname: Tagliavia
authors.forename: David
authors.initials: D
authors.lastname: Bernstein
mesh_terms: D000775:Anesthesia, Spinal / Q000379:methods; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome