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Laparoscopic groin hernia surgery: the TAPP procedure. Transabdominal preperitoneal hernia repair
D E Litwin1, Q N Pham, F H Oleniuk
1Department of Surgery, Mount Sinai Hospital, Toronto, Ont..
Objective:
To describe the technique and results of laparoscopic transabdominal preperitoneal (TAPP) hernia repair.
Design:
A case series, with a detailed description of the operative technique.
Setting:
A university affiliated hospital.
Patients:
A consecutive series of 554 patients (494 male, 60 female) who underwent laparoscopic hernia repair in a single institution. The mean follow-up was 14 months.
Interventions:
Laparoscopic TAPP hernia repair was performed in almost all patients. Simple closure was performed in a patient with a strangulated hernia, and a mesh-based repair was used in a patient with bilateral obturator hernias.
Main Outcome Measures:
Complications and recurrence.
Results:
The laparoscopic TAPP repair was successful in 550 of the 554 patients who underwent 632 hernia repairs. conversion was necessary in 4 patients. Complications were infrequent and there were no recurrences. Only 3.4% of patients were lost to follow-up. The most frequent complications were urinary retention (27) and hematoma and seroma (38) in the early postoperative period. Neuralgia (11) and hydrocele (10) also occurred. Mesh infection occurred in only 1 patient and port-site hernias in 3 patients. there was 1 death from an acute myocardial infarction.
Conclusion:
Laparoscopic TAPP hernia repair is associated with an exceedingly low recurrence rate and an acceptable complication rate.