INGUINAL HERNIA REPAIR

EXPERIENCE OF LAPAROSCOPIC TOTAL EXTAPERITONEAL APPROACH

Abstract

Objective: To evaluate early results of laparoscopic repair of inguinal hernia by totally extraperitoneal approach (TEP) performed.
Setting: At Surgical unit III, Jinnah hospital Lahore. Period: From August 2005 to July2008. Methods: 97 patients over the age of 30 years
underwent TEP repair of their inguinal hernia. Post operative assessment of the patients included pain score assessment and analgesia
requirement, along with ability to walk upright comfortably, time taken to return to normal activity and early complications like seroma,
haematoma, infection etc. Results: Post-operative pain assessment at 8 hours after surgery showed 43(44.3%) patients required extra
analgesia while 24 hours after surgery only 13(13.4%) patients required extra analgesia. Mean operative time was 95 min (range 55-130min)
for unilateral hernia. However, as experience increased with TEP repair, mean operating time decreased to 75mins in the second half of the
cases. 21(20.6%) patients at 24hrs and 51(52.6%) patients at 48hrs could walk upright without any help. Median period for return to normal
activity at domestic level was 5days (range 3-23).Incidence of early complications is shown in table-Ill. Conclusion: Our results of TEP
laparoscopic hernia repair are comparable to European experience in terms of postoperative pain, mobility of patient and rehabilitation, as well
as early complications.