Our Results of Laparoscopic Totally Extraperitoneal Repair from a Single Center: The Learning Curve and Difficulties

Özet

Introduction: The number of laparoscopic hernia repair is increasing due to decreased post-operative pain and fast recovery. However, long learning curve and need of laparoscopic skills are important problems for common practice of laparoscopic hernia repair. In this study, we presented our experience with laparoscopic totally extraperitoneal (TEP) repair especially focusing on the learning curve. Methods: The patients who underwent laparoscopic TEP repair in S.B.Ü Haydarpaşa Numune Training and Research Hospital Department of General Surgery between January 2010 and December 2016 were included in the study. The patients who were operated between 2010–2013 and 2014–2016 consisted of Groups 1 and 2, respectively. All demographic data of patients were recorded. MedCalc Statistical Software version 12.7.7 (MedCalc Software bvba, Ostend, Belgium; 2013) was used in statistical analysis. P<0.05 was accepted as statistically significant. Results: There were a total of 600 patients and cases of 716 laparoscopic TEP repair during study period. There were 15 (4.8%) recurrences in Group 1 and 4 (1%) in Group 2. Complications in Groups 1 and 2 consisted of bleeding (n= 9:3.0% vs. 7:1.7%) chronic pain (n=5:1.6% vs. 3:0.8%), hematoma (n=9:3.0% vs. 7:1.7%), wound infection (n=4:1.3% vs. 4:0.9%), and seroma (n=11:3.5% vs. 9:2.2%). Discussion and Conclusion: Both the rates of complications (recurrence and other complications) as well as the duration of operation decreased with the increase of the surgeon’s experience at the beginning and the following period in laparoscopic hernia repair. Early period operational insufficiency may play an important role in recurrent herniation.