Outcome of Laparoscopic Totally Extraperitoneal Approach with Direct Dissection and Mesh Hernioplasty in the Treatment of Inguinal Hernia

Abstract

Aim of the work: To evaluate total extraperitoneal repair with direct telescopic dissection and mesh hernioplasty for inguinal hernias. Patients and methods: This study was conducted at Gastrointestinal, Liver & Laparoscopic Surgery Unit, General Surgery Department, Tanta University Hospital, over the period from 1st Jan 2014 to last of June 2015 on 20 patients having inguinal hernia. Results: This prospective study included 20 adult patients with primary unilateral inguinal hernia, all of them were males. Age of study patients ranged from 22 to 64 years old. There were 11 patients with right inguinal hernia (55%) and 9 patients with left inguinal hernia (45%). Mean operative time was 99.30 ± 25.13 min. (with range between 60 -160 min). The mean time for analgesia was 3.75 ± 1.62 days (ranged 2 - 7 days). 24 hours post-operatively, mean visual pain score was 2.8 ± 1.15. There was one case of scrotal edema (5%). Minor surgical emphysema occurred in two cases (10%). Hospital stay ranged from 1-3 days, and the mean was 1.35 ± 0.67 days. The mean time until return to work was 14.8± 4.26 days, ranged from 7 – 21 days. The mean time of follow up was 7.6 ± 2.1 months (range 6-12 months). There were no reported cases of hernia recurrences. Conclusion: Laparoscopic TEP repair is an excellent alternative to open preperitoneal repair of inguinal hernia. Operative time is relatively long but still comparable to many of studies discussing TEP technique and improving over the time of the study indicating the need for long learning curve. This technique was proved safe, as it was not associated with major morbidity or recurrence. Complication rate was average with other studies while there was no hernia recurrence during the period of follow up.