title: [Totally extraperitoneal endoscopic surgery of inguinal hernia: results of 250 hernia repairs].
abstract: BACKGROUND
  The totally extraperitoneal endoscopic approach in the surgery of the inguinal hernia has experienced an important change, enabling a mesh to be implanted in the pre-peritoneal space with a comfortable access, as well as contributing to the advantages of minimally invasive surgery (less post-operative pain and a faster recovery). The objective of this study is to analyse the results of TEP endoscopic hernioplasty, mainly in the repair of bilateral hernias and recurrences or multiple recurrences.
  
  
  METHODS
  A total of 250 TEP endoscopic hernioplasties have been performed on 150 patients in the las 5 years. The majority (63%) of the patients subjected to surgery had bilateral hernias, and 16%, recurrent. Large and complicated iguinal-scrotal hernias were excluded. A short stay regimen was followed, establishing a protocol of, analgesia, antibiotic, antithrombotic prophylaxis, and collection of post-surgical data such as analgesia demand. The patients were given a questionnaire on discharge, in which they filled in the fields on post-surgical pain, as well as an attached satisfaction questionnaire.
  
  
  RESULTS
  The reduced need for post-surgical analgesia was noteworthy in this series, being totally unnecessary at 24h in 70 patients (46.6%), reaching 121 (80.6%) one month after surgery. There were 6 cases (4%) of reconversion, always due to opening of the peritoneal sac. There were no wound infections, 2% mild orchiepididymitis, 6 (2.4%) recurrence, and one (0.4%) inguinal neuralgia. There was a high level of satisfaction (95%).
  
  
  CONCLUSIONS
  TEP endoscopic hernioplasty is a very effective and safe procedure in the hands of experienced surgeons with specific training. It is an interesting option in bliateral and recurrent hernia as it obtains satisfactory results in terms of postoperative pain and morbidity.
authors: Servicio de Cirugía General y Aparato Digestivo, Hospital Marina Baja, Villajoyosa, Alicante, España. mcza16981@gmail.com
authors: Carmen
authors: C
authors: Zamora-Amorós
authors: Carlos
authors: C
authors: Calado-Leal
authors: Azahara
authors: A
authors: Illán-Riquelme
authors: Julio
authors: J
authors: Camacho-Lozano
authors: Roberto
authors: R
authors: Ripoll-Martín
authors: Manuel
authors: M
authors: Diego-Esteve
mesh_terms: D004724:Endoscopy; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D017060:Patient Satisfaction