Complications of laparoscopic herniorrhaphy

Abstract

Anterior inguinal hernia repair is the second-most-commonly performed abdominal operation and has been associated with low morbidity and mortality rates. The principle of laparoscopy has been applied to this surgical problem in a series of 762 patients with 841 inguinal hernias. Four types of laparoscopic repairs were conducted: (1) high ligation of the indirect inguinal hernia sac and closure of the internal ring (87 patients with 89 hernias); (2) plug and patch of the internal ring (74 patients with 87 hernias); (3) transperitoneal suture repair of the transversalis fascia to the iliopubic tract or Cooper's ligament (28 patients with 30 hernias); and (4) placement of a large prosthesis over the myopectoneal orifice (563 patients with 635 hernias). These early results indicate that the overall complication rates were low, especially when a large prosthesis was used to reinforce the myopectoneal orifice. It is concluded that laparoscopic inguinal herniorrhaphy is a safe and effective procedure with which to manage this surgical problem.

Incidence of complications following laparoscopic hernioplasty

“…The efficacy and safety of laparoscopic hernioplasty have not been generally accepted despite the good early results published by individual investigators [6,10,12,13,21,23,24,27]. Appropriate concerns have been raised about the violation of the abdominal cavity, the use of mesh in primary repairs, the use of general anesthesia, and the potential complication and recurrence rate of laparoscopic hernioplasty.…”

“…This report addresses these important questions with the results of a large multicenter study of laparoscopic hernioplasties (LH). Fitzgibbons et al [8] and MacFadyen et al [13] reported the results of differing techniques of LH from several centers and concluded that laparoscopic hernioplasty was safe and effective. Fitzgibbons reported 736 repairs in 597 patients.…”

Laparoscopic transabdominal preperitoneal approach to place a polypropylene mesh on the abdominal wall: an experimental swine model of a technique that can be used for incisional hernia repair

“…Intraperitoneal polypropylene has been associated with many complications, including wound infection [17], erosion to intraabdominal organs [15], intestinal fistulas [7,17], and mesh rejection [13]. Brandt et al [7] reported a smaller incidence of enterocutaneous fistulas among cases in which omentum is interposed between the mesh and the intestine.…”

“…The repair of inguinal hernias with preperitoneal positioning of a polypropylene mesh using the laparoscopic transabdominal preperitoneal (TAPP) approach is an accepted, safe, and widely performed procedure [13]. On the other hand, the intraperitoneal placement of a polypropylene mesh (IPOM) in incisional hernias, not performed very often, may enhance the risk of complications, essentially adhesions and fistulas [14,17].…”

La hernia inguinal en la era laparoscópica.

“…Sin embargo, con el advenimiento de la laparoscopía aplicada a la hernia inguinal (12,13,14), se gestó uno de los cambios más importantes en la historia de esta patología. Por desgracia, el entusiasmo desmedido y técnicas poco adecuadas, ocasionaron gran cantidad de recidivas (15,16,17,18,19) causando decepción y descrédito del procedimiento.…”