Laparoscopic inguinal herniorrhaphy with mesh: an 18-month experience.

One-hundred-thirty-five laparoscopic inguinal hernia repairs were performed in 110 patients over an 18 month period. In all, 75 indirect, 24 direct, 23 bilateral, 5 scrotal, and 7 recurrent hernias were repaired. Types of repairs included plug only (4%), plug and patch (19%), and large stapled patch (77%). One-hundred-six patients were male. No recurrence rates were found at 6 and 12 months postoperatively. Minimal postoperative pain was noted in nearly all cases, and disability was only 4-10 days in 96% of unilateral repairs. Patients returned to immediate unrestricted duties. The operation has evolved from a simple plug repair to a large stapled patch. Ninety-seven percent of unilateral repairs were performed in less than 80 min. Repair of recurrent hernias created less morbidity by avoidance of the old incision. Scrotal hernia repair was expedited by amputating the large sac and leaving it in place. Fifty-three percent of patients required little or no analgesics. Only four significant complications occurred in this series, including an inadvertent bladder injury, one case of persistent pain requiring conversion to open repair, one other case of dyspareunia over a plug, and one case of uncontrollable bleeding requiring a groin incision. The new technique offers minimal incision, minimal pain, and minimal disability.