Totally extraperitoneal endoscopic XXXX (TEP).

@entity1 @entity7502 @entity6378 @entity281 @entity86 @entity547 @entity169 @entity1744 @entity130
BACKGROUND: This report reviews our experience with 5,203 totally extraperitoneal (TEP) endoscopic hernia repairs performed in 3,868 @entity1 over the 7.5-year period between May 1994 and December 2001, 34.5% of whom had @entity547 and 13% recurrent @entity547 . METHODS: We performed TEP as the method of choice in more than 92% of all the @entity1 presenting with @entity169 , including those with incarcerated, strangulated, or @entity547 . After reduction of the hernial sac and appropriate dissection of the preperitoneal space, we placed a slit-free 10 x 15-cm @entity7502 mesh without the use of staple fixation. RESULTS: Altogether, 29 recurrent @entity547 (0.6%) were observed, more than 50% of which occurred during the first 2 years after the technique was introduced (1.8%). During subsequent years, the recurrence rate settled to approximately 0.3%. Regarding intraoperative complications, we observed eight @entity130 to the bladder. At this writing, no bowel @entity130 or damage to iliac vessels has been seen. Postoperatively, we noted only a single case of @entity281 . In 14 cases (0.4%), @entity86 necessitated either inguinal or endoscopic reoperation. As a further major complication, a @entity1744 caused by inadequate closure of a @entity6378 occurred in two @entity1 (0.05%). The overall reoperation rate for the 3,868 @entity1 was 0.6%. CONCLUSIONS: We consider TEP to be a procedure that carries an acceptably low complication rate, combining the advantages of minor access surgery and mesh reinforcement of the groin. This approach is associated with early postoperative return to usual activities and a very low recurrence rate.
