[Developments in inguinal hernia based on newly introduced intervention techniques in the North Rhine district]

In Germany inguinal hernia surgery has changed over the last decade from conventional repairs without alloplastic material to video-assisted minimal invasive techniques or Lichtenstein repair. Since 1991 every patient undergoing inguinal hernia repair has been documented in the North-Rhine area in a routine quality-surveillance study. A total of 173,923 patients with 192,718 groin hernias (85.26% male and 14.74% female) were operated on. In 1993 the Shouldice repair was performed in 54.2%, the Bassini operation in 26%, the transabdominal laparoscopic TAPP repair in only 3.2% of cases. In 1999 the TAPP repair was performed in 13%, the extraperitoneal video-assisted TEP repair in 14%, Lichtenstein repair in 18.5%, Shouldice repair in 35% and the Bassini operation in only 4.8%. The percentage of operations was 13.4% over the last 10 years. However, there was an increase from 12.8% in 1993 to 14.1% in 1997, and a rate of 13.5% in 1999. The following complications were observed: hematoma/seroma formation in 3.78%, wound infection in 1.15%, testicular edema in 0.37% and scrotal edema in 0.64%. The data document the introduction of three new methods for inguinal hernia repair (TAPP, TEP and Lichtenstein repair). A decrease in operations on recurrences is not observed.