title: Totally extraperitoneal (TEP) endoscopic hernia repair in elderly patients.
abstract: BACKGROUND
  Inguinal hernias are common in elderly males. We addressed outcome following totally extraperitoneal (TEP) hernia repair in patients older than 70 years.
  
  
  METHODS
  We prospectively collected data of patients >70 years with a unilateral or bilateral inguinal hernia operated in our hospital between January 2005 and January 2010 using the TEP technique.
  
  
  RESULTS
  A total of 429 patients underwent TEP hernia repair under general anaesthesia, mostly men (n = 405; 94.4%). Median age was 74 years (range 70-89). The mean pre-operative pain score was 3.7 (SD ± 2.5). Ninety-four percent of patients had an ASA score of 1 or 2. Three hundred thirty-six patients underwent a unilateral repair (78%). The conversion rate to an anterior procedure was 0.7 % (n = 3). In 8 patients (1.9%), intra-operative complications occurred, and the postoperative course was complicated in 3 patients (0.7 %). Severe complications attributable to the endoscopic approach occurred in 6 patients (1.4%): a bladder injury (n = 5) and a trocar-induced bowel perforation (n = 1). The mean postoperative pain score after 6 weeks was 1.6 (SD ± 1.2). Patients were able to resume their daily activities after a median of 7 days (range 1-42).
  
  
  CONCLUSIONS
  Totally, extraperitoneal endoscopic inguinal hernia repair in elderly patients is associated with low overall complication rates and a fast recovery. In a small proportion of patients, severe complications occur attributable to the endoscopic approach.
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands. cvoorbrood@diakhuis.nl.
authors.forename: C E H
authors.initials: CE
authors.lastname: Voorbrood
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: J P J
authors.initials: JP
authors.lastname: Burgmans
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Clevers
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: P H P
authors.initials: PH
authors.lastname: Davids
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: E J M M
authors.initials: EJ
authors.lastname: Verleisdonk
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Dalen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D016896:Treatment Outcome
keywords: Elderly; Endoscopic surgery; Inguinal hernia; Totally extraperitoneal (TEP) technique