[Laparoscopic hernioplasty]

We report our experience with laparoscopic repair of inguinal hernias since Dec. 1990. The initially used "plug & patch-technique" was abandoned because of high recurrence rates for primary hernias and other disadvantages. In Feb. 1992 we started with a transperitoneal-preperitoneal repair using closure of the defect with sutures as well as posterior wall reinforcement with polypropylene mesh. Based on established conventional techniques, the procedure has evolved and results in quick recovery and low recurrence rates. As compared to anterior techniques, a superior repair of large posterior wall defects, bilateral, femoral and especially recurrent hernias is achieved. Disadvantages are the transabdominal approach and the need of general anesthesia. The technique used in Göttingen is presented in detail. Between 2/92 and 9/93 we repaired 249 hernias (including 44 recurrences) in 207 patients. Major complications were observed in 1.6%. Up to now, we found 4 recurrences (1.6%, follow-up 87%, 5-24 months).