Outcome of totally extra-peritoneal laparoscopic hernioplasty at a tertiary care hospital Larkana

Objective: To evaluate the outcome of totally extra-peritoneal laparoscopic hernioplasty in terms of hospital stay, operative time and complications. Methods: The prospective descriptive study was carried out at the Department of Surgery, Unit-I, Chandka Medical College Teaching Hospital, Larkana, Pakistan, from September 2008 to June 2010. A total of 141 male patients above 12 years of age with reducible primary and secondary, unilateral and bilateral, direct and indirect inguinal hernia underwent total extra-peritoneal hernia repair. All the relevant details of each patient were noted and subsequently analysed statistically. Results: Overall, 100 (71%) patients had unilateral inguinal hernia and 41 (29%) had bilateral inguinal hernia. The mean age of the patients was 51±14 years. The mean operation duration was 70±19 minutes. Bilateral repairs took 20 minutes more than unilateral repairs (80 versus 59 minutes). However, the mean operative time for the last 55 (30%) cases decreased to 55±10 minutes. One (0.7%) patient had conversion to open surgery and 10 (7.1%) had minor complications; mostly scrotum seroma, that were resolved. Recurrences occurred in 2 (1.4%) cases; 1 in recurrent hernia, and 1 in bilateral direct hernia. However, no hernia ecurrence was present in the last 81 (59%) patients. The mean hospital stay was 1.4±0.6 days.Conclusion: Laparoscopic hernia repair is difficult to learn and perform, but has advantages of less post-operative pain, early recovery with minimal hospital stay, low post-operative complications and recurrence.