Laparoscopic transperitoneal mesh repair of inguinal hernia. A preliminary review of 120 cases

From april 1992 to april 1994 we performed 120 laparoscopic transperitoneal hernia repairs using a polypropylene mesh. This paper is a preliminary review of the method we used and our results. We operated upon 105 patients including 40 direct, 79 indirect and 1 femoral hernias. The inguinal region is approached transperitoneally through 3 trocars placed in the lower abdominal region. A dissection of the pre-peritoneal inguinal space is performed and a 14 x 8 cm mesh is fixed using a stapling device. We have had some peroperative complications (injury to the epigastric vessels and the vas deferens, bowel injury), mainly in our early experience with this new technique. Postoperative complications consisted of minor problems (scrotal seroma and induration of the spermatic cord) 3 infections, 1 patient with prolonged pain and 1 recurrence. Some of these problems can be resolved by adjusting the technique. There seems to be less postoperative pain and a shorter convalescence period allowing active persons to return to work earlier than with classic herniorrhaphy. Since this is a new technique, no definite conclusions can be drawn at the moment.