Hernioplastias inguinales por vía laparoscópica. Experiencia inicial en 324 casos

Abstract

IntroductionInguinal hernias are the most frequent pathologies a surgeon must know how to treat. Lately, their management with techniques using surgical mesh has become increasingly relevant, especially when repaired is done via laparoscopy. The purpose of this study is to show our initial experience in the laparoscopic treatment of inguinal hernias. Material and methodsA prospective descriptive study was carried out with all the patients submitted to laparoscopic inguinal repair at Gestion Salud Clinic in Cartagena, between June 2010 and May 2014. Special interest was drawn upon the impact of learning curve on the ocurrence of complication and the relationship between the number of tackers used with level of pain, analgesia requirement and time to return to habitual activities. ResultsA total of 412 inguinal repairs were performed in 324 patients. The average visual analog score (VAS) score at the seventh postoperative day was 5.8 (2-9) and 2 (0-8) at the thirtieth. The most painful postoperative score with more analgesic requirement and latest return to habitual activities was associated with the number of spiral staples used, the occurrence of complications, bigger body mass index, history of hernia recurrence, male sex and the younger the patient was. Hernia recurrence percentage of this series was 1.5%, with an average follow up of 26 months (14-61). ConclusionsLaparoscopic inguinal repair has a short learning curve in surgeons accustomed to laparoscopic techniques, it offers low index of complications and recurrence that never disappears, even above 100 cases. The possibility of visceral damage is always present, becoming more frequent in TAPP approach. In our experience, postoperative pain, analgesia requirement and the return to normal activities were related to fixation intensity (number of staples used).