[Endoscopic hernia repair within the scope of a total management concept]

From 1991 until 1998 there were 1832 hernioplasties in 1696 patients. Endoscopic procedures as there were the Trans Abdominal Hernioplasty (TAPP) and the Totaly Extraperitoneal Hernioplasty (TEP) are increasing as the Lichtenstein procedure. This is in opposite to the Shouldice operation. Endoscopic treatment is highly accepted and the results are as good as with other operations. The analysis of our patients shows that there is an indication for all the different procedures. We clame to use the optimal operation for each individual patient depending on clear criteria. Principally there are still the Shouldice operation without a net for the youngers and the Lichtenstein operation in local anaesthesia for elder and risk patients recommended. All others, especially those with bilateral and recurrent hernia profit from endoscopic procedures. Advantages and disadvantages for TAPP and TEP are demonstrated.