title: Complications of laparoscopic inguinal herniorrhaphy including one case of atypical mycobacterial infection.
abstract: BACKGROUND
  Although laparoscopic inguinal herniorrhaphy is considered safe, several complications may occur. This study aimed to evaluate the complications observed in 780 laparoscopic inguinal herniorrhaphies at the authors' hospital.
  
  
  METHODS
  All the patients who underwent laparoscopic inguinal herniorrhaphy at the authors' hospital during a period of 11 years were enrolled retrospectively in this study. Patient demographics, operative data, and intra- and postoperative complications were evaluated.
  
  
  RESULTS
  A total of 569 patients underwent 780 laparoscopic inguinal herniorrhaphies. The male-to-female ratio was 8.8 to 1, and the mean age was 54.8 ± 15.7 years. Hernia recurrence was recognized in 14 patients (2.5%). Intra- and postoperative complications were diagnosed in 28 (4.9%) and 35 (6.2%) patients respectively. There was no mortality. The most common intraoperative complication was extensive subcutaneous emphysema. Two patients with extensive subcutaneous emphysema had cardiac arrhythmia. Small bowel perforation and bladder perforation occurred in one patient each. One patient had extensive preperitoneal infection caused by Mycobacterium massiliense, which required mesh removal, tissue debridement, and prolonged antibiotic therapy.
  
  
  CONCLUSIONS
  Although the mortality rate is low, potentially life-threatening complications such as small bowel and bladder perforation may be experienced by patients subjected to laparoscopic herniorrhaphy.
authors.affiliation: Department of Surgery, Hospital Nossa Senhora das Graças and Hospital de Clínicas of the Federal University of Parana, Rua Bento Viana, 1140, Ap. 2202, Curitiba, PR, 80240-110, Brazil. coelhojcu@yahoo.com.br
authors.forename: Julio C U
authors.initials: JC
authors.lastname: Coelho
authors.forename: Christiano M P
authors.initials: CM
authors.lastname: Claus
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Michelotto
authors.forename: Fabiana Marques
authors.initials: FM
authors.lastname: Fernandes
authors.forename: Christian Lopez
authors.initials: CL
authors.lastname: Valle
authors.forename: Leonardo Dudeque
authors.initials: LD
authors.lastname: Andriguetto
authors.forename: Antonio C L
authors.initials: AC
authors.lastname: Campos
mesh_terms: D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000209:etiology*; D010538:Peritonitis / Q000209:etiology*; D011183:Postoperative Complications; D012008:Recurrence; D013352:Subcutaneous Emphysema / Q000209:etiology; D013526:Surgical Mesh