Laparoscopic Inguinal Hernia Repair: Optimal Technical Variations and Results in 1700 Cases

Quilici, Philippe J.; Greaney Jr., Edward M.; Quilici, Jean; Anderson, Susan
September 2000
American Surgeon;Sep2000, Vol. 66 Issue 9, p848
Academic Journal
A follow-up series of 1700 laparoscopic inguinofemoral herniorrhaphies by a single surgical team is presented (1381 patients). Two standard techniques were used: transabdominal preperitoneal (1452 cases) and totally extraperitoneal (248 cases). Mean follow-up was 5.3 years. There were 348 patients with bilateral hernias, 121 with recurrent hernias, and 27 with incarcerated hernias. Numerous technical variations were used as the study progressed. A SurgiPro mesh (USSC, Norwalk, CT) with staple/tack fixation was used in all patients. Average operating time was 41 minutes for unilateral repairs, and 97.3 per cent of the procedures were outpatient procedures. Five recurrences were reported. The postoperative permanent neuropathy rate was found to be negligible, but a 5.1 per cent rate of uncomplicated ipsilateral postoperative seromas is reported. All patients were instructed to return to unrestricted physical activities on postoperative day one. Ninety per cent of the patients were able to do so within 5 days versus 93 per cent in 7 days. Ninety-six per cent of all patients felt minimal pain and discomfort after 72 hours. There was no significant difference in recovery or morbidity between the transabdominal preperitoneal and totally extraperitoneal repairs. To date laparoscopic inguinal herniorrhaphy continues to be a difficult procedure with a significant learning curve. The reported surgical performance data and the described optimal technical variations make this procedure a viable and competitive repair in the surgical management of inguinofemoral hernia.


Related Articles

  • Totally extraperitoneal repair for bilateral inguinal hernia: does mesh configuration matter? Halm, J. A.; Heisterkamp, J.; Boelhouwer, R. U.; den Hoed, P. T.; Weidema, W. F. // Surgical Endoscopy;Oct2005, Vol. 19 Issue 10, p1373 

    Background: The endoscopic preperitoneal approach has numerous advantages for the reconstruction of bilateral inguinal hernias. Repair may be achieved using either one large or two small meshes. The aim of this study was to investigate whether one of the techniques was superior in...

  • Synchronous Laparoscopic Vasectomy and Hernia Repair. Kasirajan, Karthikeshwar; Govindrajan, Satish; Erzurum, Victor Z.; Lopez, Jose; Lopez, Raul // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr99, Vol. 9 Issue 2, p177 

    Discusses a case of a laparoscopic hernia repair with synchronous vasectomy. Background of the patient with right inguinal hernia; Description of laparoscopic vasectomy; Treatment.

  • A survey of inguinal hernia repair in Wales with special emphasis on laparoscopic repair. Sanjay, P.; Woodward, A. // Hernia;Oct2007, Vol. 11 Issue 5, p403 

    Background: The National Institute of Clinical Excellence (NICE) recently published its guidance on the use of laparoscopic repair for inguinal hernias. This study aimed to assess the likely uptake of laparoscopic surgery for inguinal hernias in Wales. In addition the current...

  • Why does NICE not recommend laparoscopic herniorraphy? Motson, Roger W // BMJ: British Medical Journal (International Edition);5/4/2002, Vol. 324 Issue 7345, p1092 

    Discusses the reluctance of NICE to recommend laparoscopic repair of hernias based on economic considerations. Reference to studies which show laparoscopic herniorraphy is less painful postoperatively than traditional open repair; Why the true costs of laparoscopic repair are lower than those...

  • Biomechanical properties of lightweight versus heavyweight meshes for laparoscopic inguinal hernia repair and their impact on recurrence rates. Hollinsky, Christian; Sandberg, Simone; Koch, Thomas; Seidler, Sabine // Surgical Endoscopy;Dec2008, Vol. 22 Issue 12, p2679 

    Laparoscopic inguinal hernia repair can be performed using light- or heavyweight meshes. Apart from the size of the mesh, its friction coefficient (μ0) and flexural stiffness are of crucial importance to avoidance of hernia recurrence. In the current biomechanical study, tensile tests were...

  • Inguinodynia after Laparoscopic Inguinal Hernia Repair. Aldoseri, Abdulkareem // World Journal of Laparoscopic Surgery;Sep-Dec2010, Vol. 3 Issue 3, p135 

    Objectives: The objective of this literature review is to see if changing the site of the mesh from outside to inside has any effect on the occurrence of posthernia repair pain. And also to review different author's opinion about causes occurrence and management of post-mesh inguinal pain....

  • Tissue Glue in Laparoscopic Inguinal Hernia Repair: A Retrospective Comparative Analysis. Mahanta, Abhijit; Mishra, R. K. // World Journal of Laparoscopic Surgery;Sep-Dec2010, Vol. 3 Issue 3, p165 

    During the last two decades, there have been two revolutions in inguinal hernia repair surgery. First, the introduction of tension-free hernia repair by Liechtenstein in 1989 and then the application of laparoscopic surgery to the treatment of inguinal hernia in the early 1990s. In this context,...

  • Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Reddy, V. M.; Sutton, C. D.; Bloxham, L.; Garcea, G.; Ubhi, S. S.; Robertson, G. S. // Hernia;Oct2007, Vol. 11 Issue 5, p393 

    Background: Seroma are common early postoperative complications encountered in laparoscopic inguinal hernia repair. Previous anecdotal evidence from our surgical practice suggested a lower incidence of postoperative seroma formation with direct hernia repairs when the lax...

  • Recurrence following endoscopic extraperitoneal inguinal hernioplasty. Lau, H. // Hernia;Oct2007, Vol. 11 Issue 5, p415 

    Recurrence rate is the utmost outcome parameter in determining the clinical effectiveness of any hernia surgery. Between June 1999 and September 2004, six patients presented with recurrent hernia after endoscopic totally extraperitoneal inguinal hernioplasty (TEP). Four of the six recurrences...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics