Laparoscopic totally extraperitoneal inguinal hernia repair: 10-year experience of a single surgeon

Background The advantages of laparoscopic hernia repair on reducing postoperative pain and an earlier return to normal activities with similar recurrence rate have been confirmed by various studies. The objective of this study was to assess the effectiveness of laparoscopic totally extraperitoneal repair. Methods Patients who underwent laparoscopic inguinal hernia repair between December 2000 and December 2010 were enrolled retrospectively. Patient demographics, operative and postoperative course, and outpatient follow-ups were studied. Results Of the 1371 cases in 1178 patients, 1328 cases (96.8%) were laparoscopic totally extraperitoneal repair and 43 cases (3.2%) represented other laparoscopic procedures--intraperitoneal onlay mesh or transabdominal preperitoneal techniques. There was only 1 conversion from a laparoscopic procedure to open surgery. The number of recurrent hernias was 129 (11.0%). Most of the recurrent hernias were secondary to open hernia repair. The mean operative time was 26 ± 18 minutes for unilateral hernias and 39 ± 29 minutes for bilateral hernias. The incidence of intraoperative complications was 3.8%. The overall postoperative morbidity rate was 15.3%, mainly representing seroma and pain. The recurrence rate was 0.5%. Conclusions If performed by experienced laparoscopic surgeons, laparoscopic totally extraperitoneal repair is an excellent mode of hernia repair for most types of inguinal hernias.