The totally extraperitoneal (TEP) laparoscopic hernia repair.

In recent years endoscopic techniques using mesh implantation have been added to the many options for the repair of inguinal hernia to diminish postoperative pain, shorten the reconvalescence period and improve the recurrence figures of the classical repair. The purpose of this paper is to evaluate our first experiences gained by applying the TEP laparoscopic hernia repair. Between March and December 1996, 20 laparoscopic herniorrhaphies were performed with complete extraperitoneal balloon dissection. A large polypropylene prosthesis was inserted to cover all potential defects. The follow-up was 2-10 months. There were 10 indirect, 6 direct, 1 combined direct and indirect, 1 femoral and 2 scrotal hernias. Age (26-86 years) and operative time (52-120 mins) had a wide range. Hospital stay lasted from 1-5 days. Morbidity was low: scrotal emphysema (3), peritoneal lesion (2) and palpable mesh crease (1) occurred in a few cases. No recurrences have been seen so far. It seems that the TEP laparoscopic hernia repair is a highly successful procedure with minimal morbidity. Preliminary results are promising. Further experiences and long term follow-up studies will determine the future of laparoscopic hernia surgery.