A Single Institution’s Experience with Transperitoneal Laparoscopic Hernia Repair

A Study of the Correlation between Pre-Operative Risk Factors and Various Complications Occurring during and after Laparoscopic Procedures

“…2 patients with chronic pelvic pain and 1 port site infection. The results were comparable to studied done by Leibl et al [13] and McCormack et al [14] . We did 2 laparoscopic intraperitoneal only mesh surgeries.…”

Laparoscopic hernia repair - the facts, but no fashion

“…The longer times of operation and the application of singleuse instruments are responsible for the higher operational expenses of endoscopic surgery in these studies, which led to additional costs of US $ 484-550 per patient. The median operating time of 73 min is the same as in the abovecited randomised trials (median operating time 70 min), but clearly longer than in the large prospective series [60,66] (median operating time 42-45 min). These results, which where obviously achieved after overcoming the learning curve, show no difference to data of experienced surgeons using conventional techniques [operating time, 40-50 min Shouldice, 55 min transinguinal preperitoneal mesh repair (TIPP)] [77].…”

“…So far, to our knowledge, nine TAPP and seven TEP studies with a prospective non-randomised [53][54][55][56][57][58][59][60][61][62][63][64][65][66] design, which are clearly past the problems of the learning curve, have been published. Data from 5802 inguinal hernia repairs for the TAPP and 2592 for the TEP procedure were presented with a median patient age of 52 years in both groups.…”

Laparoscopic hernia repair?TAPP or/and TEP?

“…During the endoscopic hernia repair the lateral cutaneous femoral nerve is particularly at risk: an incidence of 0.2%-0.3% must be expected in large patient groups [14,21]. This rate is, thus, clearly lower than for conventional repair techniques [23]. Much more important, however, is the neuralgia as a consequence of clip lesions to a nerve, which results from the fixation efforts for the mesh.…”

“…This intermediate laparoscopy enables, on the one hand, diagnostic assessment of the intraperitoneal situation but, on the other hand, however, it necessitates safe intraperitoneal action that might be obstructed and complicated by adhesions. This is precisely why surgical safety measures have to be observed meticulously, especially during the initial establishment of the pneumoperitoneum [14,23]. In contrast to TEP, the ensuing preperitoneal dissection can be kept limited and defect-adjusted, paying attention to sufficient parietalisation for the following foldless placement of the mesh.…”