Hernia Repair Via Laparoscopic Transabdominal Preperitoneal (TAPP) Method: Our Clinical Outcomes in County State Hospital

INTRODUCTION: Inguinal hernia repair is one of the most commonly performed operations in general surgery. A great number of methods has been described. Laparoscopic hernia repair was initiated to be performed after 1990s and adopted by many centers. The objective of this study is to evaluate our outcomes in laparoscopic transabdominal preperitoneal hernia repair which we performed in the county state hospital in the light of the literature.
METHODS: Outcomes of patients for whom inguinal hernia repair was performed via laparoscopic transabdominal preperitoneal method between the dates of November 2015 and August 2017 were evaluated retrospectively.
RESULTS: 33 patients were included in the study, 30 being male and 3 being female. Median age value was 46 (ranging between 19 and 75). A total of 44 repairs were performed, being right-sided inguinal hernia in 18 (54.6%) patients, left-sided in 4 (12,1%) patients and bilateral in 11 (33.3%) patients. Mean duration of hospital stay was 1,09 (±0,29) days and ranging between 1 and 2. Postoperatively, 2(6.1%) patients were observed to develop pseudorecurrence (seroma), 1 (3%) patient to develop hematoma and 2 (6.1%)patients to develop orchitis. Mean follow-up duration of the patients was varying between 6 to 27 months, with a mean of 13,76( ±5,84). During follow-up of 33 patients, 1 (3,1%) patient was determined to develop recurrence.
DISCUSSION AND CONCLUSION: Laparoscopic hernia repair has been known to have some advantages, including smaller incisions, more rapid recovery, less pain and earlier return to daily activities. However, process of learning takes longer compared to the open method. It was reported that no difference occurred in recurrence rates in individuals who received a training on the laparoscopic method during specialization training or during further educational processes. In conclusion, we considered that this method can also be safely performed in county hospitals by individuals who received training on the laparoscopic method.

Laparoskopik Transabdominal Preperitoneal (TAPP) Yöntem ile Fýtýk Onarýmý; Ýlçe Devlet Hastanesi Klinik Sonuçlarýmýz

GÝRÝÞ ve AMAÇ: Ýnguinal herni onarýmý, genel cerrahide en sýk yapýlan ameliyatlardan birisidir. Çok sayýda yöntem tanýmlanmýþtýr. Laparoskopik fýtýk onarýmý 1990'lý yýllardan sonra yapýlmaya baþlanmýþ ve birçok merkez tarafýndan benimsenmiþtir. Çalýþmamýzýn amacý, ilçe devlet hastanesinde yaptýðýmýz laparoskopik transabdominal preperitoneal fýtýk onarýmý sonuçlarýmýzý literatür eþliðinde deðerlendirmektir.
YÖNTEM ve GEREÇLER: Kasým 2015- Aðustos 2017 tarihleri arasýnda laparoskopik transabdominal preperitoneal yöntem ile inguinal herni onarýmý yapýlan hastalarýn sonuçlarý retrospektif olarak incelendi.
BULGULAR: 30’u erkek, 3’ü kadýn olmak üzere 33 hasta çalýþmaya dahil edildi. Yaþ ortanca deðeri 46( 19 ile 75 arasý) idi. 18(%54,6) hastada sað, 4(%12,1) hastada sol ve 11(%33,3) hastada bilateral herni olmak üzere toplam 44 onarým yapýldý. Hastanede kalýþ süresi ortalama 1,09( ±0,29) gün ve 1 ile 2 arasýnda idi. Ameliyat sonrasý 2(%6,1) hastada psödonüks(seroma), 1(%3) hastada hematom, 2(%6,1) hastada orþit gözlendi. Hastalarýn takip süresi 6 ile 27 ay arasý olup ortalama 13,76( ±5,84) idi. 33 hastanýn takibinde 1(%3,1) hastada nüks tespit edildi.
TARTIÞMA ve SONUÇ: Laparoskopik fýtýk onarýmýnýn; küçük kesiler yapýlmasý, daha erken iyileþme, daha az aðrý ve günlük aktiviteye erken dönüþ saðlamasý gibi avantajlarý olduðu bilinmektedir. Ancak öðrenme süreci açýk yönteme göre daha uzundur. Uzmanlýk eðitiminde veya daha sonraki süreçte laparoskopik yöntemin eðitimini alan kiþilerde nüks oranýnda farklýlýk gözlenmediði bildirilmiþtir. Sonuç olarak laparoskopik yöntem eðitimini almýþ kiþiler tarafýndan ilçe hastanelerinde de bu yöntemin güvenle yapýlabileceði kanatindeyiz.