title: Laparoscopic inguinal hernia repair: a prospective evaluation at Eastern Nepal.
abstract: BACKGROUND
  Inguinal hernias have been treated traditionally with open methods of herniorrhaphy or hernioplasty. But the trends have changed in the last decade with the introduction of minimal access surgery.
  
  
  METHODS
  This study was a prospective descriptive study in patients presenting to Surgery Department of B. P. Koirala Institute of Health Sciences, Dharan, Nepal with reducible inguinal hernias from January 2011 to June 2012. All patients >18 years of age presenting with inguinal hernias were given the choice of laparoscopic repair or open repair. Those who opted for laparoscopic repair were included in the study.
  
  
  RESULTS
  There were 50 patients, age ranged from 18 to 71 years with 34 being median age at presentation. In 41 patients, totally extraperitoneal repair was attempted. Of these, 2 (4%) repairs were converted to transabdominal repair and 2 to open mesh repair (4%). In 9 patients, transabdominal repair was done. The median total hospital stay was 4 days (range 3-32 days), the mean postoperative stay was 3.38±3.14 days (range 2-23 days), average time taken for full ambulation postoperatively was 2.05±1.39 days (range 1-10 days), and median time taken to return for normal activity was 5 days (range 2-50 days). One patient developed recurrence (2%). None of the patients who had laparoscopic repair completed complained of neuralgias in the follow-up.
  
  
  CONCLUSIONS
  Laparoscopic repair of inguinal hernias could be contemplated safely both via totally extra peritoneal as well as transperitoneal route even in our setup of a developing country with modifications.
authors.affiliation: Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Vikal Chandra
authors.initials: VC
authors.lastname: Shakya
authors.affiliation: Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Shasank
authors.initials: S
authors.lastname: Sood
authors.affiliation: Department of Anesthesia, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Bal Krishna
authors.initials: BK
authors.lastname: Bhattarai
authors.affiliation: Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Chandra Shekhar
authors.initials: CS
authors.lastname: Agrawal
authors.affiliation: Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Adhikary
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009390:Nepal; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
keywords: Extraperitoneal repair; inguinal hernia; laparoscopy; seroma; transabdominal approach