Transabdominal preperitoneal hernia repair (TAPP). Results of 1,000 completed operations]

It was the aim of this report to evaluate the laparoscopic transabdominal preperitoneal hernia repair (TAPP) which has been standardized at our department. Along with the demographic characterisation of 795 patients with 1000 inguinal hernia repairs we report about complications and early recurrences. The patient data were collected prospectively. The rate of follow-up amounted to 79.9% with an average follow-up of 1 year. The complications were divided into intraoperative, minor, major, as well as severe ones. In 30 repairs minor complications (3%) were detected. Major (n = 28) and severe (n = 9) complications were detected in 3.7% of the cases. There were two deaths, 3 patients with an intestinal obstruction due to adhesions (2 segmental small bowel resections), two patients with testicular atrophy, two mesh infections, two trocar hernias, 6 surgical revisions for removal of hematomas, one exploration of a testicle, 4 diagnostic laparoscopies for suspected recurrences with a negative result, and 15 patients with a nerve irritation syndrome. The early rate of recurrence was 0.7%. In 6 cases primary hernias had been repaired and in one case a recurrent hernia. The recurrent hernias became apparent in an average of 2 years (minimum 2.5 months, maximum 36 months) after surgery. The results of the clinical study demonstrate an acceptable rate of complications and a low rate of early recurrences. Based on these data we recommend the laparoscopic transabdominal preperitoneal technique and see an ideal indication in the case of bilateral, recurrent and femoral hernias.