The Impact of High Surgical Volume on Outcomes From Laparoscopic (Totally Extra Peritoneal) Inguinal Hernia Repair.
OBJECTIVE
Laparoscopic hernia repair is characterised by a steep learning curve for the surgeon, and proficiency and outcomes are dependent on experience. The aim of this study was to compare laparoscopic totally extra peritoneal (TEP) inguinal hernia repair outcomes conducted by a single surgeon as experience changed over time.


METHODS
Clinical records of 100 consecutive patients who underwent laparoscopic TEP inguinal hernia repair (n=113 hernias) at Kent and Canterbury Hospital by a single laparoscopic surgeon over a four-year period were reviewed for postoperative outcomes. Outcomes were compared with a previous cohort of patients undergoing TEP repair in the preceding three years.


RESULTS
One patient experienced chronic postoperative pain, but there were no recurrences, wound infections, haematomas, or conversions compared to three recurrences, three conversions to open operations, one haematoma, and one episode of postoperative pain in the preceding period.


CONCLUSIONS
Laparoscopic TEP inguinal hernia repair can be further improved with surgical proficiency and high surgical volumes.
Registrar Surgery, Department of General and Vascular Surgery, Kent and Canterbury Hospital , Canterbury, CT1 3NG .
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Aikoye
Locum Consultant Surgeon, Queen Elizabeth the Queen Mother Hospital , Margate, CT9 4AN .
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M
Harilingam
Locum Consultant Surgeon Department of General and Vascular Surgery, Kent and Canterbury Hospital , Canterbury, CT1 3NG .
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Khushal
General surgery; Hernia; Laparoscopic surgical procedures