RESUMO
Objective To discuss the value of laparoscopic total extraperitoneal repair(TEP) for inguinal hernia.MethodsBetween 2005 and 2007,82 consecutive patients with inguinal hernia at 97 sides underwent TEP by laparoscopy in our hospital.Among the cases [76 men and 6 women with a mean age of 52 years(21 to 88)],9 had unilateral direct inguinal hernia,50 showed unilateral indirect inguinal hernia,and 9 suffered from bilateral indirect inguinal hernia,6 cases were found having bilateral indirect inguinal hernia complicated with direct hernia,and 8 were recurrent cases of indirect inguinal hernia.Results In the patients,5 showed massive postoperative abdominal adhesion;one of them was converted to open surgery because of severe injury to the peritoneum,the other 4 were treated by continuous suture using 5-0 absorbable thread.The operation time for laparoscopic surgery ranged from 30 to 180 minutes(58 minutes for unilateral operation,and 97 minutes for bilateral operation on average).No patient needed analgesics after the procedure.The mean hospital stay for this series was 7 days(range: 4 to 12).Nine patients developed seromas of the scrotum,and was then cured by local drainage and physical therapy.The 82 patients were followed up for 13 to 38 months with a mean of 26 months,during which no one had recurrence.Conclusion As a safe and minimally invasive procedure,which leads to less trauma and pain,as well as quick recovery,TEP is especially suitable for patients with recurrent or bilateral hernias.
