Laparoscopic inguinal hernia repair: a report of 2056 cases        ZHANG Yun, CHEN Xin, LI Jian-wen, et al. Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Clinical Minimally Invasive Surgery Center, Shanghai 200025, China
Corresponding author: LI Jian-wen, E-mail: ljw5@yeah.net
Abstract    Objective    To evaluate the clinical effect of laparoscopic inguinal hernia repair (LIHR). Methods    The clinical data of 2056 cases (2473 hernias) underwent LIHR between January 2001 and December 2011 at Ruijin Hospital, Shanghai Jiaotong University School of Medicine were analyzed retrospectively. There were 1005 TAPP in 874 cases, 1458 TEP in 1175 cases and 10 IPOM in 7 cases. The 2473 hernias included 1481 indirect hernias (59.9%), 525 direct hernias (21.2%), 225 recurrent hernias (9.1%), 206 complex hernias (8.3%) and 36 femoral hernias (1.5%). The classification of hernia: there were 95 Type I hernias (3.8%), 995 type Ⅱ hernias (40.2%), 1157 type Ⅲ hernias (46.8%) and 226 type IV hernias (9.1%). All procedures were performed by the same surgical team and the selection of the techniques was decided by the surgeons. The follow-up period ranged from 3 to 60 months (median 35 months). Results There was one conversion from attempted TAPP to Lichtenstein repair because of the extensive adhesion. No analgetic was required. Cases returned to usual activities in 2 weeks and 4 weeks accouted for 99.0% and 99.9% respectively. The overall recurrence rate was 0.24% (6/2473). Both TAPP and TEP had 3 recurrences. There were 3 severe complications: port-site hernia, bowel injury and mechanical intestinal obstruction. Other complications included 129 seroma (5.2%), 34 urinary retention (1.4%), 26 transient neurapraxia (1.1%) and 3 paralytic ileus (0.12%). Conclusion    LIHR is a safe and efficient technique. With reasonable selection and standard operation, LIHR can achieve good clinical result.