The application of modified transabdominal preperitoneal prosthetic laparoscopic hernioplasty

Eleven hundred patients who underwent laparoscopic primary hernioplasty from 2002 to 2007 at our hernia center are included in our prospective study. A modified transabdominal preperitoneal (TAPP) prosthetic technique was applied in 1100 cases of hernioplastic operations. The modified technique consisted of using the needle with thread and needle-hook to close the hernia ring and partial preperitoneal dissecting to place the mesh. A self-made mesh is used. The lift-insert technique is applied to fix the mesh. There were 882 indirect and 218 direct hernias. Mean operative time is 20 minutes for 1-sided hernia and 35 minutes for two-sided hernia. A total of 1002 (95%) patients were discharged within 48 hours. No mesh infection or migration has been reported. No postoperative adhesive ileus has been reported. Ten patients have been treated with analgesic medication. There are 9 recurrences (0.9%) reported with a 98% follow-up over 1-6 years. We find that the modified laparoscopic transabdominal preperitoneal hernioplasty is a safe and efficacious treatment option for primary inguinal hernia.