title: Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study.
abstract: BACKGROUND
  Surgery for inguinal hernia continues to evolve. The most recent development in the field of surgery for inguinal hernia is the emergence of laparoscopic inguinal hernia surgery (LIHS) which is challenging the gold standard Lichtenstein's tension free mesh repair. Our centre has the largest series of LIHS from any Armed Forces hospital. The aim of this study was to analyze the short and long term outcomes at our center since its inception.
  
  
  METHODS
  Retrospective review of prospectively maintained data base of 501 LIHS done in 434 patients by a single surgeon between April 2008 and October 2013. Preoperative, intraoperative, postoperative and follow-up data was analyzed with emphasis on the recurrence rates and the incidence of inguinodynia.
  
  
  RESULTS
  402 (92.6%) patients had primary hernias and 367 (84.6%) patients had unilateral hernias. Of the 501 repairs, 453 (90.4 %) were done totally extraperitoneal approach and 48 (9.6 %) were done by the transabdominal preperitoneal approach. The mean operative time for unilateral and bilateral repairs was 40.9 ± 11.2 and 76.2 ± 15.0 minutes, respectively. The conversion rate to open surgery was 0.6%. The intraoperative, and early and late postoperative complication rates were 1.7%, 6.2% and 3%, respectively. The incidence of chronic groin pain was 0.7% and the recurrence rate was 1.6%. The median hospital stay was 1 day (1-5 days).
  
  
  CONCLUSIONS
  We, in this series of over 500 repairs have demonstrated that feasibility as well as safety of LIHS at our centre with good short and long term outcomes.
authors.affiliation: Professor and Head, Dept of Surgery, Army College of Medical Sciences and Consultant (Surgery and GI Surgery), Base Hospital Delhi Cantt, New Delhi 110010, India.
authors.forename: C K
authors.initials: CK
authors.lastname: Jakhmola
authors.affiliation: Assistant Professor, Dept of Surgery, Army College of Medical Sciences and Classified Specialist (Surgery) and GI Surgeon, Base Hospital Delhi Cantt, New Delhi 110010, India.
authors.forename: Ameet
authors.initials: A
authors.lastname: Kumar
keywords: Chronic groin pain; Inguinal hernia; Laparoscopic repair; Recurrence rates; Totally extraperitoneal repair