Long-term Outcomes of Laparoscopic Totally Extraperitoneal Inguinal Herniorrhaphy

ABSTRACT

PURPOSE: Laparoscopic inguinal herniorrhaphy, especially laparoscopic TEP repair, has become a standard method of inguinal herniorrhaphy. Favorable short-term results of laparoscopic inguinal hernia repair, compared with open surgery, have been reported, however, data on the long-term outcome are limited. Based now on more than 55 months of follow-up, we report here on the long-term results for patients who underwent laparoscopic TEP inguinal hernia repair. METHODS: Between January 2002 and December 2007, of patients who underwent laparoscopic TEP repair for an inguinal hernia by a single surgeon, 180 patients who have had a follow-up check with a physical examination or telephone interview were enrolled. RESULTS: A total of 196 TEP procedures in 180 patients (age range 15~88 years; men, 88.3%) were performed successfully without conversion to transabdominal preperitoneal (TAPP) or open surgery. During the follow-up period of more than 55 months (55~20 months), chronic inguinal discomfort or pain was noted in 14 patients (n=14, 7.7% per patient or 7.1% per repair) and the severity of pain was mild (n=11), moderate (n=2), or severe (n=1). In most patients, occurrence of groin pain was very infrequent and the duration of the pain varied from a few seconds to a few minutes. There was one suspicious recurrence (0.5%), which was comparable to that of open surgery. Four cases of mesh infection (2.03%) were noted. Chronic mesh infection may be more frequent than previously reported. Otherwise, most of the patients were satisfied with their results. CONCLUSION: According to the long-term results of the study, laparoscopic TEP is a safe procedure for repair of inguinal hernia, with a low incidence of chronic pain and very low recurrence rate. However, among mesh-related complications, mesh infections have become increasingly important. For clinicians the possibility of mesh infection should be promptly considered in any patient who has undergone hernia surgery involving mesh, and who has any manifestations of abdominal wall.