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Prosthetic Inguinal Hernia Repair Using a Laparoscopic Extraperitoneal Approach.
MedLine Citation:
PMID:  10401046     Owner:  NLM     Status:  Publisher    
The preperitoneal technique offers several advantages over conventional anterior approaches in the surgical repair of inguinal hernias: direct access to the posterior inguinal anatomy, clear visibility of all possible hernial defects, ability to circumvent scar tissue and intra-abdominal adhesions, and ease of effecting difficult repairs. A preperitoneal prosthetic procedure has been successfully used, performed laparoscopically, to repair 163 indirect, 163 direct, and one femoral inguinal defects. In the approach used, a piece of polypropylene mesh, placed extraperitoneally, is used to reinforce or replace the transversalis fascia. In only one of 197 patients (0.5%) was it necessary to convert to an open procedure; this patient had a severely incarcerated hernia. Almost all patients were discharged on the day of surgery, and all returned to normal activities within 7 days. There were few complications, and the recurrence rate in the series of 300 repairs was only 0.3%. One patient required a second procedure because of a retained indirect hernia. Based upon these results and the experience of others using a similar approach, the laparoscopic extraperitoneal prosthetic repair is advocated for patients with recurrent, as well as bilateral and complicated inguinal defects.
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Publication Detail:
Journal Detail:
Title:  Seminars in laparoscopic surgery     Volume:  1     ISSN:  1071-5517     ISO Abbreviation:  Semin Laparosc Surg     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1999-07-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9432584     Medline TA:  Semin Laparosc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  116-122     Citation Subset:  -    
Metropolitan Hospital, Atlanta, GA, USA
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