Laparoscopic extraperitoneal repair of inguinal hernias

The world of surgical laparoscopy is evolving. Laparoscopic prosthetic inguinal hernia repair is gaining rapid and wide acceptance. This experience consisted of 144 hernia repairs in 105 patients (40 bilateral, 31 recurrent, and 33 unilateral nonrecurrent hernias), treated through an extraperitoneal laparoscopic repair. When compared with transabdominal repair, operative time and postoperative recovery were similar, with some advantages related to the avoidance of intraabdominal manipulation and potential related complications. In spite of a relatively short follow-up (up to 40 months), there were no recurrences in this series. Morbidity rate was acceptable (16.1%), mainly reported as minor complications. Anatomical and technical skills to perform the operation are required and achieved through training. Extraperitoneal hernia repair with synthetic mesh is safe and feasible, with the advantages of being associated with less pain, rapid return to full activities, and the already proven milder systemic responses following interventional laparoscopy.