title: Outcome of totally extra-peritoneal laparoscopic hernioplasty at a tertiary care hospital Larkana.
abstract: OBJECTIVE
  To evaluate the outcome of totally extra-peritoneal laparoscopic hernioplasty in terms of hospital stay, operative time and complications.
  
  
  METHODS
  The prospective descriptive study was carried out at the Department of Surgery, Unit-I, Chandka Medical College Teaching Hospital, Larkana, Pakistan, from September 2008 to June 2010. A total of 141 male patients above 12 years of age with reducible primary and secondary, unilateral and bilateral, direct and indirect inguinal hernia underwent total extra-peritoneal hernia repair. All the relevant details of each patient were noted and subsequently analysed statistically.
  
  
  RESULTS
  Overall, 100 (71%) patients had unilateral inguinal hernia and 41 (29%) had bilateral inguinal hernia. The mean age of the patients was 51+/-14 years. The mean operation duration was 70+/-19 minutes. Bilateral repairs took 20 minutes more than unilateral repairs (80 versus 59 minutes). However, the mean operative time for the last 55 (30%) cases decreased to 55+/-10 minutes. One (0.7%) patient had conversion to open surgery and 10 (7.1%) had minor complications; mostly scrotum seroma, that were resolved. Recurrences occurred in 2 (1.4%) cases; 1 in recurrent hernia, and 1 in bilateral direct hernia. However, no hernia recurrence was present in the last 81 (59%) patients. The mean hospital stay was 1.4+/-0.6 days.
  
  
  CONCLUSIONS
  Laparoscopic hernia repair is difficult to learn and perform, but has advantages of less post-operative pain, early recovery with minimal hospital stay, low post-operative complications and recurrence.
authors.affiliation: Department of Surgery, Chandka Medical College & Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. dr_smghani@yahoo.com
authors.forename: Abdul Ghani
authors.initials: AG
authors.lastname: Shaikh
authors.forename: Muhammad Ishaque
authors.initials: MI
authors.lastname: Soomro
authors.forename: Mohammad Saleem
authors.initials: MS
authors.lastname: Shaikh
authors.forename: Aijaz Ahmed
authors.initials: AA
authors.lastname: Memon
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010537:Peritoneum; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult