Long-term results of laparoscopic totally extraperitoneal inguinal herniorrhaphy

The short-term advantages of laparoscopic totally extraperitoneal mesh herniorrhaphy (TEP) are well documented, but the long-term results remain unclear. The purpose of the present paper is to clarify this issue with particular reference to hernia recurrence and chronic pain.

A retrospective case series of 100 consecutive patients undergoing TEP 5 years ago by a single surgeon were followed up prospectively with a focused physical examination and interview. Data collected included recurrence, chronic groin pain, tenderness, sensory disturbance, activity or occupational limitation, and personal satisfaction.

During the period between 1997 and 1999, 100 consecutive patients underwent 110 TEP hernia repairs. The mean age was 56 years. Two patients were excluded from the study because they had had open repairs for technical reasons. Median follow up was 64 months. Follow up was complete (interview and physical examination) in 88% and partial (telephone interview only) in a further 5%. There was no major morbidity or mortality. Hernia recurrence rate was 1%. Chronic pain occurred in 14 patients (14%), which was mild in 13 patients and moderate in one. Ninety-eight per cent of patients were satisfied with their repair and would or had recommended TEP to others.

Long-term results of TEP demonstrate it to be an effective and safe procedure with a low recurrence and low prevalence of chronic pain that is generally of a mild, infrequent nature.