Initial Experience of Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair in 40 Cases

Evaluation of cases with laparoscopic repair of hernia totally extraperitoneal (TEP) at our centre was done to know its effectiveness in view of surgical time, intraoperative events, immediate and late postoperative complications, hospital stay, time to return to work and its cost effectiveness.

A prospective study was carried out on 40 patients in the Department of Surgery (unit 3 and 4) at Hamdard Institute of Medical Sciences and Research New Delhi, between March 2016 and Feb 2017. Patients with clinical diagnosis of reducible inguinal hernia, direct or indirect, unilateral or bilateral, complete or incomplete and not operated for the same previously were included in the study.

Male predominance (92.5%) was seen. 45% were in the age group of 20-39yrs. 67.5% had pain and discomfort. 30% had apprehension of tumour. Average surgical time in initial 20 cases was 94 minutes and in next 20 cases it was 82 minutes. One patient was converted to open surgery. Most of our patients were ambulatory within 24 hrs and resumed their normal work in seven to ten days. Need for analgesia was only for 3 days. In two patients we had noticed seroma formation. One patient had pain in left inguinal region and there is no recurrence noted in our follow up. Patients were reviewed once a week for 2 weeks, biweekly for 6 weeks, every month for 10 months. In our study duration of follow up ranged from 6 months to 1 year.

Our initial experience in performing laparoscopic TEP repair for inguinal hernia have found that it is a safe procedure with slightly longer learning curve. But with experience even the operative time will get shortened. Patient recovery is faster with less need of analgesia and the postoperative complications are rare. In view of shorter hospital stay and early return to normal work makes it a cost effective procedure.