Outcome of the laparoscopic total extraperitoneal approach with direct dissection and mesh hernioplasty in the treatment of inguinal hernias

Aim
The aim of this study was to evaluate the laparoscopic total extraperitoneal (TEP) approach with direct telescopic dissection and mesh hernioplasty for inguinal hernias.
Patients and methods
This study was conducted at the Gastrointestinal, Liver, and Laparoscopic Surgery Unit, General Surgery Department, Tanta University Hospital, over the period from 1 January 2014 to last of June 2015 on 20 patients having inguinal hernias.
Results
This prospective study included 20 adult patients with primary unilateral inguinal hernias, and all of them were males. The age of patients ranged from 22 to 64 years. There were 11 (55%) patients with right inguinal hernias and nine (45%) patients with left inguinal hernias. The mean operative time was 99.30±25.13 min (range: 60–160 min). The mean analgesia time was 3.75±1.62 days (range: 2–7 days). Twenty-four hours postoperatively, mean visual pain score was 2.8±1.15. There was one (5%) case with scrotal edema. Minor surgical emphysema occurred in two (10%) cases. Hospital stay ranged from 1 to 3 days, and the mean value was 1.35±0.67 days. The mean time until return to work was 14.8±4.26 days (range: 7–21 days). The mean follow-up time was 7.6±2.1 months (range: 6–12 months). There were no reported cases of hernia recurrences.
Conclusion
The laparoscopic TEP repair is an excellent alternative to open preperitoneal repair of inguinal hernias. The operative time was relatively long, but comparable with many studies discussing the TEP technique, which improved over the time of the study, indicating the need for a long learning curve. This technique was proved to be safe, as it was not associated with major morbidity or recurrence. The complication rate was average as compared with other studies, and there was no hernia recurrence during the follow-up period.