[Inguinal hernia in adults. Subperitoneal prosthesis under celioscopic control (370 operated sides in 320 patients...

The authors present their technique of groin hernias repair by putting of a very tall (15 X 15 cm for unilateral hernias, or 30 X 15 cm for bilateral hernias). Polypropylene prosthesis in subperitoneal space by laparoscopic access. From may 1991 to june 1993, 320 patients were operated on 370 sides (50 bilateral hernias) with a total of 411 hernias. The first results are analysed: there was in particular no conversion and infection. Recurrences were studied only on the patients operated since at least one year: There were 1 recurrence (0.6%) on 163 sides operated in 141 patients with a mean average follow up of 17 months. There were 2 occlusions (on 370 sides operated), by incarcerated small bowel in the preperitoneal space after partial failed of the peritoneal suture. The first patient was reoperated on at the fifteenth postoperative day (chronic occlusion) by laparotomy. The second patient was reoperated on at the fifth postoperative day by laparoscopy which permit to reduce the small bowel in the abdominal cavity and closing the peritoneum with a new suture. It should be observed that 74 patients (23%) were operated on epidural anesthesia.