LAPAROSCOPIC TOTALLY EXTRAPERITONEAL INGUINAL HERNIA REPAIR; OUR EXPERIENCES IN 52 CASES. Laparoskopik total ekstraperitoneal inguinal herni onar?m?: 52 vakal?k deneyimimiz.

摘要

Two revolutions in inguinal hernia repair surgery have occurred during the last two decades. The first was the intro-duction of tension-free hernia repair by Lichtenstein in 1989 and the second was the application of laparoscopic surgery to the treatment of inguinal hernia in the early 1990s. The purposes of this study were to assess our first experiences of laparoscopic totally extraperitoneal (TEP) repair in inguinal hernias. This study was planned prospectively. Patients who under-went an elective unilateral inguinal hernia repair at General Surgery departments in Afyon Kocatepe University Faculty of Medicine, Haseki Education and Research Hospital and Avrasya Hospital, Istanbul, from 2005 and 2008 were enrolled in this study. Patient demographic data, operative and postoperative courses, complications and outpatient follow-ups were recorded and analyzed. A total of 52 hernia repairs were included in the study. All were repaired by TEP technique. There were 2 hernias (4%) that required conversion to open technique. The mean operative time was 39 minutes. Most of the patients were discharged at the second day of the surgery. The incidence of intraoperative complications was 8%. The incidence of postoperative complications was 8% and the incidence of early recurrence rate was 4%. In the hands of experienced laparoscopic surgeons, laparoscopic hernia repair can be by done successfully using the TEP technique. ?ZET Son iki dekatta kas?k f?t??? cerrahisinde iki geli?me orta-ya ??kt?. ?lki 1989’da Lichtenstein taraf?ndan yerle?tirilen gergin olmayan (tension-free) onar?m, ikincisi ise 1990 y?l?n?n ba?lar?nda laparoskopik cerrahinin kas?k f?t??? onar?m?nda kullan?lmas? oldu. Bu ?al??mada ama?, kas?k f?t??? onar?m?nda laparoskopik total ekstraperitoneal (TEP) yakla??mdaki ilk deneyimlerimizi de?erlendirmekti. ?al??ma prospektif olarak planland?. Kocatepe üniversitesi T?p Fakültesi, Haseki E?itim ve Ara?t?rma Hastanesi ve Avrasya Hospital genel cerrahi kliniklerinde 2005-2008 y?llar? aras?nda elektif olarak tek tarafl? kas?k f?t??? tamiri yap?lan hastalar ?al??maya al?nd?. Hastalar; demografik ?zellikleri, ameliyat süresi, ameliyat s?ras?ndaki ve sonras?ndaki sonu?lar, komplikasyonlar ve takipleri a??s?ndan de?erlendirildi. ?al??maya laparoskopik kas?k f?t??? onar?m? yap?lan 52 hasta dahil edildi. F?t?k onar?m? TEP tekni?i ile yap?ld?. ?ki hastada (%4) a???a d?nülmek durumunda kal?nd?. Ortalama ameliyat süresi 39 dakika olarak hesapland?. Hastalar?n ?o?u ameliyat sonras? 1. günde taburcu edildi. ?ntraoperatif komplikasyon oran? %8, postoperatif komplikasyon oran? %8 ve erken nüks oran? %4 olarak bulundu. Deneyimli laparoskopik cerrahlar?n elinde TEP tekni?i kullan?larak kas?k f?t??? tamiri ba?ar?l? bir ?ekilde yap?labilir.