ABSTRACT
Objective To evaluate some key steps influencing success rate in process of totally laparoscopic extraperitoneal herniorrhaphy(TEPH). Methods Between October 2006 and May 2009,we performed totally laparoscopic extraperitoneal herniorrhaphy in 98 patients with like procedures and under the same condition. Results The critical procedures of the operation are related to the establishment of the extraperitoneal cleavage. We used one-way anova analysis. The operation time in different peritoneal burst sites have no significant difference (P > 0. 05), but the operation time in different burst periods have significant difference(P <0. 05). The timing at which the burst occurs significantly influence the length of operation, while the rapture sites don't influence the operation time. The conversion rate was higher and operation time was longer between the cases with the rapture occurrence in early period and in mid and late period. Postoperatively 98 patients were followed up. The follow-up rate was 100%. The median follow-up time was 18 months. Three patients complained local discomfort one month after operation, which subsided after 2 months. There was no recurrence or chronic pain case. Conclusion The burst of the peritoneum during the process of establishing extraperitoneal cleavage significantly influences the success rate of TEPH.