Reduction in the number of clips used and careful attention to the anatomic nerve course during preparation and placement of mesh led to a significant reduction in the occurrence of nerve irritations. In the last 100 patients who underwent laparoscopic hernia repair, only one nerve lesion was seen.
The results of our randomized trial of 176 patients comprising primary hernias [Shouldice versus transabdominal preperitoneal approach (TAPP)] showed only slight advantages for the laparoscopically operated group compared to the conventionally operated group: less subjective pain (significant only on fifth postoperative day, p < 0.05), reduced analgesic requirement (significant only on third postoperative day, p < 0.05), significantly shorter duration of hospitalization (4 days vs. 6 days, p < 0.05) and faster return to work (27 days vs. 34 days, NS). Regarding the incidence of recurrences, there was no significant difference between the groups (two recurrences vs. one recurrence) within a follow-up period of 2 years. Postoperative morbidity was similar and the total cost was less for the TAPP group.
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