Effectivity of laparoscopic inguinal hernia repair (TAPP) in daily clinical practice: early and long-term result.

Abstract

The aim of the study was to investigate the effectiveness of laparoscopic inguinal hernia repair in daily clinical practice. All patients admitted to the hospital for surgery of an inguinal hernia during a 1-year period were prospectively documented and included in a follow-up study. The follow-up was performed at least 5years after surgery and consisted of a clinical examination, ultrasound investigation and a questionnaire. From January 2000 to January 2001 a total of 1208 inguinal hernias in 952 patients were consecutively operated by a total of 11 general surgeons in daily clinical routine. Of the patients, 98.02% were operated on laparoscopically with the transabdominal preperitoneal patch plasty technique (TAPP) and 1.98% had an open repair. The frequency of intraoperative and early postoperative complications was 2.8%. The complication rate in the patients presenting a complex hernia was not higher than in patients with uncomplicated unilateral hernias. Life-threatening complications were seen in four patients (bowel lesion-0.4%), but all four patients presented extensive adhesions in the abdominal cavity after previous abdominal surgery. The follow-up rate after 5years was 85.3%. After 5years the recurrence rate was 0.4% and the rate of severe chronic pain 0.59%. None of the patients took analgesics or had to change his occupation. Laparoscopic repair can be applied to all types of inguinal hernia as a daily routine procedure with low rates of recurrences and chronic pain. Limiting factor may be extensive adhesions after previous major surgery in the lower abdomen.