Laparoscopic hernia repair

Seventy-nine patients (106 repairs) with inguinal hernias underwent laparoscopic transabdominal preperitoneal hernia repair. The patients included 73 males and 6 females, ranging in age from 19 to 86 years. Twenty-five percent had undergone previous abdominal surgery, and 19% had recurrent hernias. Preoperative diagnosis was 40 right inguinal hernias (RIH), 33 left inguinal hernias (LIH), and 6 bilateral hernias. Intraoperatively, 30 RIH, 22 LIH (1 patient also had a left incisional hernia), 26 bilateral hernias, and 2 femoral hernias were diagnosed and repaired. Twenty patients (25%) had contralateral hernias diagnosed intraoperatively. Average operating time for unilateral repairs was 76 minutes and for bilateral repairs was 110 minutes. Forty-three percent of patients underwent day-care surgery, and 35% were discharged on the first postoperative day. Postoperative complications included 6 cases of transient neuralgias (7%), 3 cord/scrotal hematomas (4%), 1 trocar site hematoma (1%), and 1 case of chronic pain (1%). Follow-up ranged from 1 to 12 months with no recurrences. This study demonstrates the importance of laparoscopy in identifying undiagnosed contralateral hernias, that bilateral hernias can be repaired with no additional morbidity, and that there are high rates of success and safety in laparoscopic hernia repairs in a community hospital.