[Laparoscopic transabdominal preperitoneal hernioplasty. Evaluation of complications due to transabdominal approach]. / Laparoskopische transabdominale präperitoneale Hernienplastik. Evaluation der zugangsbedingten Komplikationen.

INTRODUCTION: Since the introduction of laparoscopic hernioplasty the TAPP procedure (transabdominal preperitoneal approach) has become the most widely used technique. Many surgeons have changed to the total extraperitoneal approach (TEP), because they fear the consequences of a peritoneal lesion. METHOD: We evaluated our results with TAPP in a retrospective study, with special attention to complications caused by the approach. We operated on 460 hernias in 390 patients in a period of 5 years. RESULTS: Complication rates and recurrence rates were similar to those after TEP. There was a marked learning curve with decrease of both rates during the evaluated years. There were no complications related to the transabdominal approach other than trocar hernias, the rate of which could be reduced by eliminating the learning curve and by using smaller trocar diameter. CONCLUSION: We see no reason to change from TAPP to the TEP technique.

[Illness behavior: design for an empirical study of the determining factors]. / Krankheitsverhalten: Entwurf für eine empirische Untersuchung der bestimmenden Faktoren

A large gap is existing between the system of medical services and the "consumer". It is necessary to reinforce preventive attitudes and behavior should prepare the fundamental concepts. A research design is presented.