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Laparoscopic inguinal hernia repair. A preliminary experience
D J Winchester1, L G Dawes, D D Modelski
1Surgical Service, Veterans Affairs Lakeside Medical Center, Chicago, Ill.
Objective:
To evaluate the safety and efficacy of laparoscopic inguinal hernia repair.
Design:
Nonrandomized trial.
Setting:
Veterans Affairs hospital and a large university hospital.
Patients:
The study included 38 patients (36 male and two female) who had an acceptable risk for general anesthesia, presented electively, and gave informed consent; patients were excluded for whom general anesthesia had a high risk or who had incarcerated or strangulated hernias.
Intervention:
Laparoscopic inguinal hernia repair was performed with general anesthesia through bilateral, lower-abdominal, 12-mm lateral rectus sheath ports with an umbilical 30 degrees viewing laparoscope. After the peritoneum was incised and flaps were raised, an onlay patch of polypropylene mesh, secured with staples, covered both indirect and direct hernia regions in each patient. Small hernia sacs were usually reduced or excised.
Results:
From December 1991 through October 1992, 40 inguinal hernias were repaired; two patients had bilateral hernias. There were 22 indirect and 17 direct inguinal hernias and one femoral hernia. Nine of the hernias repaired were recurrent, and five were sliding hernias. Complications occurred in nine patients, but there were no recurrences during a median follow-up of 26 weeks. All but one patient resumed preoperative activities by 7 days after the operation.
Conclusions:
Laparoscopic inguinal hernia repair is an effective operation with low morbidity. Long-term follow-up is needed to determine the durability of the repair.