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Endoscopic extraperitoneal herniorrhaphy in 316 patients
A A Massaad1, M A Fiorillo, A Hallak
1Department of Surgery, Staten Island University Hospital, New York, USA.
Journal of Laparoendoscopic Surgery
|February 1, 1996
Summary
Endoscopic extraperitoneal herniorrhaphy (EEPH) offers a safe and efficient alternative for groin hernia repair, comparable to open preperitoneal methods. This minimally invasive technique utilizes small incisions, reducing patient recovery time.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Hernia Repair Techniques
Background:
- The posterior approach for groin hernia repair is highly effective but requires large incisions, limiting its use.
- Anterior approaches may not offer the same repair solidity as posterior methods.
- Endoscopic extraperitoneal herniorrhaphy (EEPH) aims to replicate the benefits of the posterior approach with minimal invasiveness.
Purpose of the Study:
- To evaluate the safety and efficiency of endoscopic extraperitoneal herniorrhaphy (EEPH).
- To compare EEPH outcomes with traditional open preperitoneal hernia repair.
- To assess the feasibility of EEPH for various types of groin hernias.
Main Methods:
- A retrospective study of 316 male patients undergoing 405 EEPH procedures.
- Inclusion of diverse hernia types: indirect, direct, pantaloon, and femoral.
- Use of polypropylene mesh for all repairs, with follow-up in 89% of patients.
Main Results:
- A low conversion rate to open surgery (2.2%) and a low recurrence rate (1.2%).
- Complication rate of 5.7%, including urinary retention, hematoma, and nerve neuralgia.
- EEPH demonstrated comparable safety and efficiency to open preperitoneal repair.
Conclusions:
- Endoscopic extraperitoneal herniorrhaphy is a viable and effective alternative for groin hernia repair.
- EEPH offers a minimally invasive option with acceptable complication and recurrence rates.
- Experienced laparoscopists can successfully utilize EEPH for various groin hernia repairs.