Consolidated five-year experience with laparoscopic inguinal hernia repair.
BACKGROUND
After the introduction of laparoscopic hernia repair to the National Health Service (NHS), we studied the benefits and practicality of carrying out this specialised hernia repair technique in a District General NHS hospital.


METHODS
Patients with groin hernia were stratified into groups for day-surgery or inpatient care based on Trust guidelines. Patients underwent laparoscopic trans-abdominal pre-peritoneal (TAPP) inguinal hernia repair by a single consultant surgeon. Patients were followed-up in the clinic. All data were collected prospectively on a structured proforma. Postal questionnaire was sent to 100 randomly selected patients who had surgery more than two years ago and responses were evaluated.


RESULTS
A total of 830 hernias were operated upon in 572 patients, aged between 16 and 89 years. Three hundred and twelve patients had the operation as a day-case procedure, and the remaining 260 were treated as inpatients. Incidental hernias were discovered in 19.1% of patients, and were treated simultaneously.


CONCLUSIONS
The laparoscopic tension-free TAPP method of hernia repair, as done here, is cost-effective and efficacious. Most patients can be treated as day-cases. A low recurrence rate (0.36%) with low morbidity makes it an attractive method for routine treatment of groin hernias in the NHS.
Singhal
T
T
General Surgery, Princess Royal University Hospital, Farnborough, Kent, BR6 8ND, UK. tasneemtarun@hotmail.com
Balakrishnan
S
S
Grandy-Smith
S
S
El-Hasani
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome