Long-term results after laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair under spinal anesthesia.
BACKGROUND
Laparoscopic transabdominal preperitoneal (TAPP) repair is indicated for recurrent and bilateral inguinal hernias and traditionally is performed under general anesthesia. However, the feasibility of performing TAPP under spinal anesthesia has been recently reported by our team.


OBJECTIVE
To assess the long-term results of TAPP repair under spinal anesthesia for primary inguinal hernia.


METHODS
Between January 2006 and October 2009, 94 consecutive patients with primary unilateral inguinal hernia were submitted to laparoscopic transabdominal preperitoneal repair under spinal anesthesia. We looked at the immediate postoperative outcome as well as the long-term outcome, mainly recurrences and incidence of chronic pain.


RESULTS
One patient experienced a scrotal hematoma, one patient a trocar site infection, two patients were diagnosed with an operation-related orchitis, while 31 patients (33 %) developed symptoms of urinary retention. At a median follow-up of 35 months (range 14-59), four patients (4.3 %) were diagnosed with a recurrence, while 89 % of patients reported satisfied from the procedure in the long-term. Chronic pain was not encountered in any of the patients studied. Four patients (4.3 %) reported an intermitted foreign body sensation and/or rigidity and two patients (2.1 %) numbness in the operated inguinal area.


CONCLUSIONS
Laparoscopic TAPP hernia repair under spinal anesthesia is associated with satisfactory short- and long-term results. Use of regional anesthesia instead of the traditional general anesthesia does not seem to adversely affect the quality of repair, and moreover, it offers the patient an attractive anesthetic alternative.
Department of Surgery, University Hospital of Larissa, Biopolis Campus, 411 10, Larissa, Greece. gtzovaras@hotmail.com
G
G
Tzovaras
D
D
Symeonidis
G
G
Koukoulis
I
I
Baloyiannis
S
S
Georgopoulou
C
C
Pratsas
D
D
Zacharoulis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology*; D017060:Patient Satisfaction; D012008:Recurrence; D012677:Sensation; D013526:Surgical Mesh / Q000009:adverse effects; D013997:Time Factors