Developments in inguinal hernia based on newly introduced intervention techniques in the North Rhine district

Abstract

In Germany inguinal hernia surgery has changed over the last decade from conventional repairs without alloplastic material to video-assisted minimal invasive techniques or Lichtenstein repair. Since 1991 every patient undergoing inguinal hernia repair has been documented in the North-Rhine area in a routine quality-surveillance study. A total of 173,923 patients with 192,718 groin hernias (85.26% male and 14.74% female) were operated on. In 1993 the Shouldice repair was performed in 54.2%, the Bassini operation in 26%, the transabdominal laparoscopic TAPP repair in only 3.2% of cases. In 1999 the TAPP repair was performed in 13%, the extraperitoneal video-assisted TEP repair in 14%, Lichtenstein repair in 18.5%, Shouldice repair in 35% and the Bassini operation in only 4.8%. The percentage of operations was 13.4% over the last 10 years. However, there was an increase from 12.8% in 1993 to 14.1% in 1997, and a rate of 13.5% in 1999. The following complications were observed: hematoma/seroma formation in 3.78%, wound infection in 1.15%, testicular edema in 0.37% and scrotal edema in 0.64%. The data document the introduction of three new methods for inguinal hernia repair (TAPP, TEP and Lichtenstein repair). A decrease in operations on recurrences is not observed.