Laparoscopic Totally Extraperitoneal Hernia Repairs: a Case Series Analysis


Traditionally, inguinal hernias have been treated with open Lichtenstein hernioplasty. But in the last 2 decades, the trends have changed with the introduction of laparoscopic inguinal hernia repair techniques mainly by totally extraperitoneal herniorrhaphy. This was a case series analysis of 160 consecutive patients who underwent totally extraperitoneal repair and were included accrual between January 2015 and August 2018 in our single tertiary center. Patient demographics, details of the surgery, postoperative Visual Analogue Scale, return time to work, early and late postoperative complications, recurrence, and chronic pain were evaluated. A hundred seventy-eight repairs were performed in the study cohort (median age, 46.3 years; range, 22–84 years; men, 93%). The mean follow-up was 15 months (range = 12–30). Mean hospital stay time was 22.6 h (range 15–27). The mean surgery time was 55 min (range 35–110). Second day postoperative mean Visual Analogue Scale was 2.3 (range 1–5). The mean return time to their routine work was 8.3 days (range 5–17). Seroma (10%), scrotal pain (9%), scrotal paresthesia (6%), and hydrocele (6%) were the most commonly noted complications. Recurrence was detected in 4 (2.5%) patients. Recurrences were noted at 1st week and 6th month following surgery. Chronic groin pain was reported by 4 (2.5%) patients. Totally extraperitoneal hernia repair has become increasingly applicable among surgeons due to less postoperative pain, short return time to routine work, acceptably few complications, and recurrence rates compared with the other inguinal herniorrhaphy techniques.

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We thank Dr. Mustafa Uygar Kalaycı for encouraging us to perform laparoscopic repairs.

Author information




Study conception and design: Yasin Kara and Hakan Bölükbasi

Acquisition of data: Yasin Kara

Analysis and interpretation of data: Yasin Kara

Drafting of manuscript: Yasin Kara and Hakan Bölükbasi

Critical revision: Yasin Kara and Hakan Bölükbasi.

Corresponding author

Correspondence to Hakan Bolukbasi.

Ethics declarations

Approval was given by the ethical committee of Ministry of Health, University of Health Science, Kanuni Sultan Süleyman Training and Research Hospital—no.: KAEK/2019.04.96. This study was carried out according to the principles of the Helsinki Declaration. All the patients were routinely informed and provided their written consent.

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The authors declare that they have no conflict of interest.

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Kara, Y., Bolukbasi, H. Laparoscopic Totally Extraperitoneal Hernia Repairs: a Case Series Analysis. Indian J Surg (2020).

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  • Total extraperitoneal approach
  • Laparoscopic surgery
  • Complications
  • Recurrence
  • Return time to work