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South African Journal of Surgery

On-line version ISSN 2078-5151

S. Afr. j. surg. vol.50 n.4 Cape Town Nov. 2012

 

GENERAL SURGERY

 

Outcome of laparoscopic inguinal hernia repair in a South African private practice setting

 

 

C I McGuireI; R J BaigrieII; D TheunissenI; N L FernandesIII; L R ChapmanIII

IMB ChB, FCS (SA); Department of General Surgery, University of Cape Town
IIBSc, MB ChB, MD, FRCS (Eng); Department of General Surgery, University of Cape Town
IIIMB ChB.; Department of General Surgery, University of Cape Town

Correspondence

 

 


ABSTRACT

OBJECTIVES: The aim of this study was to determine the recurrence and complication rates of laparoscopic inguinal hernia repair performed in a private practice in Cape Town.
DESIGN AND SUBJECTS: An unselected cohort of 507 patients who underwent laparoscopic totally extraperitoneal (TEP) inguinal hernia repair before September 2005 were included in this study, thus ensuring a minimum 5-year follow-up. Patient demographic data, clinical notes, operating notes and outpatient follow-up notes were studied. Patients were interviewed telephonically regarding hernia recurrence, chronic pain and technique preference if they had previously undergone an open repair. All data collected were recorded on an electronic spreadsheet. The primary outcome parameter was recurrence. The secondary outcome parameters were postoperative and long-term complications.
RESULTS: Of the 507 patients, 267 were contactable telephonically. There were 384 hernia repairs with a mean follow-up of 8.8 years. There were 9 recurrences (2.3%). The overall complication rate was 7.9%. Two per cent of patients suffered from chronic groin pain with gradual improvement since surgery. Sixteen per cent of patients had had previous open repair of an inguinal hernia, either on the ipsilateral or the contralateral side, and all judged the open repair to have been more painful.
CONCLUSIONS: The recurrence and complication rates for laparoscopic TEP inguinal hernia repair in this practice are low and comparable to the best reported series. There is a low incidence of persistent postoperative pain with the laparoscopic technique, and it is the technique preferred by patients who previously underwent an open repair.


 

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REFERENCES

1. Ger R. The management of certain abdominal herniae by intraabdominal closure of the neck of the sac. Ann R Coll Surg Engl 1982;64:342-344.         [ Links ]

2. McCormack K, Scott NW, Go PM, Ross S, Grant AM, EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003;(1):CD001785. [http://dx.doi.org/10.1002/14651858. CD001785]        [ Links ]

3. Fitzgibbons RJ, Filipi CJ, Quinn TH. Inguinal Hernias. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE, eds. Schwartz's Principles of Surgery. 8th ed. New York: McGraw-Hill, 2005:1354.         [ Links ]

4. Lau H, Patil NG, Yuen WK, Lee F. Learning curve for unilateral endoscopic totally extraperitoneal (TEP) inguinal hernioplasty. Surg Endosc 2002;16(12):1724-1728. [http://dx.doi.org/10.1007/s00464-001-8298-0]        [ Links ]

5. Choi YY, Kim Z, Hur KY. Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia. Can J Surg 2012;55(1):33-36. [http://dx.doi.org/10.1503/cjs.019610]        [ Links ]

6. Fitzgibbons RJ Jr, Camps J, Cornet DA, et al. Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial. Ann Surg 1995;221(1):3-13.         [ Links ]

7. Neumayer L, Giobbie-Hurder A, Jonasson O, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 2004;350(18):1819-1827. [http://dx.doi.org/10.1056/NEJMoa040093]        [ Links ]

8. Watson DI, Jamieson GG. Antireflux surgery in the laparoscopic era. Br J Surg 1998;85(9):1173-1184. [http://dx.doi.org/10.1046/j.1365-2168.1998.00829.x]        [ Links ]

9. Schirmer BD, Edge SB, Dix J, Hyser MJ, Hanks JB, Jones RS. Laparoscopic cholecystectomy. Treatment of choice for symptomatic cholelithiasis. Ann Surg 1991;213(6):665-676; discussion 677.         [ Links ]

10. Champault GG, Rizk N, Catheline JM, Turner R, Boutelier P. Inguinal hernia repair: totally preperitoneal laparoscopic approach versus Stoppa operation: randomized trial of 100 cases. Surg Laparosc Endosc 1997;7(6):445-450.         [ Links ]

11. Khoury N. A randomized prospective controlled trial of laparoscopic extraperitoneal hernia repair and mesh-plug hernioplasty: a study of 315 cases. J Laparoendosc Adv Surg Tech A 1998;8(6):367-372.         [ Links ]

12. Andersson B, Hallen M, Leveau P, Bergenfelz A, Westerdahl J. Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial. Surgery 2003;133(5):464-472. [http://dx.doi.org/10.1067/msy.2003.98]        [ Links ]

13. Johansson B, Hallerback B, Glise H, Anesten B, Smedberg S, Roman JBS. Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: A randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg 1999;230(2):225.         [ Links ]

14. The MRC laparoscopic groin hernia trial group. Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet 1999;354:185-190. [http://dx.doi.org/10.1016/S0140-6736(98)10010-7]        [ Links ]

15. Wright DM, Kennedy A, Baxter JN, et al. Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial. Surgery 1996;119(5):552-557.         [ Links ]

16. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc 2009;23(3):482-486. [http://dx.doi.org/10.1007/s00464-008-0118-3]        [ Links ]

17. Pokorny H, Klingler A, Schmid T, et al. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia 2008;12(4):385-389. [http://dx.doi.org/10.1007/s10029-008-0357-1]        [ Links ]

18. Davis CJ, Arregui ME. Laparoscopic repair for groin hernias. Surg Clin North Am 2003;83(5):1141-1161.         [ Links ]

19. Felix E, Scott S, Crafton B, et al. Causes of recurrence after laparoscopic hernioplasty. A multicenter study. Surg Endosc 1998;12(3):226-231.         [ Links ]

20. Ferzli GS, Frezza EE, Pecoraro AM Jr, Ahern KD. Prospective randomized study of stapled versus unstapled mesh in a laparoscopic preperitoneal inguinal hernia repair. J Am Coll Surg 1999;188(5):461-465.         [ Links ]

21. Smith AI, Royston CM, Sedman PC. Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc 1999;13(8):804-806.         [ Links ]

22. Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant AM. Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev 2005;(1):CD004703. [http://dx.doi.org/10.1002/14651858.CD004703.pub2]        [ Links ]

23. Heikkinen TJ, Haukipuro K, Koivukangas P, Hulkko A. A prospective randomized outcome and cost comparison of totally extraperitoneal endoscopic hernioplasty versus Lichtenstein hernia operation among employed patients. Surg Laparosc Endosc 1998;8(5):338-344.         [ Links ]

24. Grant AM. Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia 2002;6(1):2-10. [http://dx.doi.org/10.1007/s10029-002-0050-8]        [ Links ]

25. Eklund A, Montgomery A, Bergkvist L, Rudberg C, Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy (SMIL) study group. Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 2010;97(4):600-608. [http://dx.doi.org/10.1002/bjs.6904]        [ Links ]

 

 

Correspondence:
CI McGuire
(drcolinmcguire@yahoo.co.uk)

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