Analysis of guideline conformity, surgical techniques, devices, consumables, and outcomes of the first 100 cases of laparoscopic inguinal hernia repair in adults during institutional hernia programme in a single surgical center

Abstract

OBJECTIVE: The aim of this study is to elucidate the guideline conformity and to analyze the surgical techniques, outcomes, and the use of devices and consumables for the first 100 cases of laparoscopic inguinal hernia (IH) repair performed during an institutional hernia programme (IHP) in a single surgical center. METHODS: This is a retrospective review of the first consecutive 100 cases of laparoscopic IH repair performed during IHP. Patient's demographic, operation techniques, the use of devices and consumables, and outcomes are reviewed. RESULTS: A total of 185 IHs were laparoscopically repaired in 100 male patients with a mean age of 37.86 (range: 24–68) years from May 2015 to April 2019. Common indications for laparoscopic IH repair are bilateral IH (n = 85) and recurrences after the previous open repair (n = 11). A total extraperitoneal repair (TEP) was performed in 96 patients, and transabdominal preperitoneal repair was performed in four patients. The mean operation time was 35.97 (range: 10–90 min). Electrosurgical energy, surgical suction, and laparoscopic scissors were used in seven, four, and six patients, respectively. All the surgeries performed with low-cost standard polypropylene meshes. Surgical takers used in seven patients to anchor the mesh (n = 6) and close the peritoneal defect (n = 1). Conversion to open procedure was required in a single patient. The single hematoma was the only complication encountered. Seven patients developed unilateral recurrences after TEP repair for bilateral IH during the mean follow-up period of 2 years and 3 months. All the patients were discharged within 23 h of the surgery. CONCLUSIONS: This study shows a higher level of guideline conformity of the laparoscopic IH repair with acceptable level of recurrence while using a minimum number of costly devices and consumables.