Laparoscopic treatment of inguinal hernias. A personal approach.

Laparoscopic hernia repair has suffered from a lack of careful anatomical appreciation and the application of sound surgical principles. Key anatomical landmarks which must be clearly identified in every hernia repair are Cooper's ligament, the umbilical artery and the epigastric vessels. The preperitoneal transabdominal mesh repair is the technique advocated by the authors. Between January 1991 and February 1993, 180 hernias were repaired. One hernia has recurred. Morbidity was minimal, with no major complication. The hospital stay was 1.3 days and the majority of patients returned rapidly to full activity. The best indications for laparoscopic hernia repair are recurrent hernias, a large hernia in patients with a weak muscular abdominal wall and bilateral hernias, for which the technique is considered ideal.