Laparoscopic hernioplasty by transabdominal preperitoneal approach analysis and review in 267 cases

Introduction: Despite the increasing acceptance of the TAPP-procedure by patients and general practitioners this method has to be further examined. in addition to the classic surgical criteria of examination, subjective aspects of patient comfort must be taken into consideration as they are getting more and more significant for the evaluation of different methods. Methods: According to this objective patients were clinically examined and questioned about specific topics of quality of life after TAPP-operations. Furthermore, the patients documentation (medical report/OP-report) was evaluated retrospectively. Results: Between 1995 and 1998 endoscopic transabdominal preperitoneal hernioplasty was used for 267 inguinal hernia repairs in 204 patients. 155 patients could be interviewed about the operative outcome and 199 operated inguinal hernias could be examined physically and sonographically. The recurrence rate was 2.5%, the rate of major complications was 4.4%. Postoperative pain-syndrome were found as a major complication in only two cases (1.3%), postoperative nervous disorders could be diagnosed in 3.5% of the patients. Further subjective complaints were seen in 19% of the patients. The median postoperative period until the resumption of sexual intimacy was approximately two weeks, but six male patients reported about long-lasting pain in copulation (3.9%). Discussion: With regard to the aspects mentioned above, the TAPP-procedure provided exellent results in the examined patient cohort and therefore turned out to be at least comparable with competitive methods. Nevertheless, the postoperative pain in sexual activity that a few male patients complained of represents a new aspect which has to be further investigated.