Farooq Ahmad, Muhammad Farooq Afzal, Muhammad Saad Faisal, Ejaz Langah.
Outcome of Totally Extraperitoneal (TEP) Inguinal Hernia Repair; an experience of 40 cases at services Hospital, Lahore.
Pak J Med Health Sci Jan ;8(2):442-5.

Aim: To describe our initial experience of laparoscopic TEP hernia repair in term of operative time, operative difficulties, complications, hospital stay and return to normal activities. Study design: Case series. Place and duration of study: Services Hospital, Lahore from April 2011 to November 2013. Methods: Forty consecutive male patients with inguinal hernia were included. A structured training of TEP hernia repair was imparted to the operating surgeons. TEP hernia repair was performed in all these patients. Demographic data, operative time, operative difficulties, complications and return to daily activities were recorded and analysed using SPSS version 16. Results: The mean age of patients was 36.63+12.00 years (range 18–66 years). Thirty (75%) patients had unilateral hernias, 7(17.5%) had bilateral and 3(7.5%) had recurrent hernias. The mean operative time for unilateral hernia was 96.57 + 5.08 minutes (range), for bilateral hernias was 103.20 +9.82 minutes and for recurrent hernia was 117.67+9.82 minutes). The most common operative difficulty was accidental pneumoperitoneum, occurred in 10(25%) cases. Operative complications included troublesome bleeding in 1(2.5%) cases, clipping of epigastric vessel in 1(2.5%) cases. None of the patients had conversion to open repair. Postoperatively, seroma in 2(5%) patients, chronic pain in 1 (2.5%) cases, majority of patients 38(95%) resumed their routine life activities in 07 days. There was no recurrence or mortality seen in the series. Conclusion: TEP hernia repair is an acceptable and feasible surgical option for the management of inguinal hernias and its learning curve can be shortened by structured training.

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