The Clinical Experience Of Laparoscopic Totally Extraperitoneal Hernia Repair In175Cases

Objective To assess the safety and effectiveness of laparoscopicinguinal hernia repair.Methods Data of the patients who underwent laparoscopic totallyextraperitoneal hernia repairs with complete information between Dec.2008and Dec.2013were retrospectively analyzed in our hospital.Results Of175cases,137patients with unilateral hernia and38patients that had bilateral hernias，including9cases with recurrent herniain all patients. Among213hernia repairs，we performed11direct herniarepairs，199indirect hernia repairs，1femoral hernia operation and2composite hernia surgeries. There were211TEP in175patients.1casewas converted from TEP to TAPP，1case to open surgery. The operatingtime was ranged from40mins to160mins. The mean operating time was56mins for unilateral hernia and103mins for bilateral hernias. Theaverage amount of bleeding was24ml (the range was10ml to60ml).The rate of peritoneal tear happened in22cases was12.57percentsduring the operation with no injure of bladder、intestinal tract、iliac vesselsand spermatic cord. The most common postoperative complications werescrotum/inguinal region seroma or hematoma that accounted for19cases(10.86%)，4cases of abdominal incision errhysis，4cases of urinaryretention，2cases had urinary tract infection，1case appeared stress ulcer，1case had the incomplete ileus. The patients stayed in hospital for3to6 days postoperatively in the early stages. But in recent2years，thepostoperative hospital stay was2to3days. The follow-up lasted for4-63months with a median of29.5months.5cases appeared chronic inguinalpain after operation，1case had recurrence. The mean hospitalizationexpenses were (17294.32±526.74) RMB (ranged from10129.76to28943.85RMB).Conclusion TEP is a safe and effective surgical method for thetreatment of inguinal hernia with advantages of less postoperative pain，fewer complications，rapid recovery，low recurrence rate and minimallyinvasive wounds，but it is necessary for surgeons to perform50-100operations before quickly going through the learning curve.