[Two-year results of celioscopic hernioplasties using an intraperitoneal ePTFE patch. A prospective multicenter study of 184 cases. Groupe CHIC (Cure des hernies inguinocrurales sous coelioscopie)]

Abstract

Two hundred and four groin hernias in 173 patients were laparoscopicaly treated using an intraperitoneal ePTFE patch and prospectively studied. Two patients died for diseases unrelated to their hernia nor their hernioplasty. Eight patients were lost to follow up (5.2%), 163 were followed up for at least 1 year, without recurrence at their last examination, and 155 were followed up for at least 2 years. This study concerns these 155 patients accounting for 184 hernioplasties. Twelve recurrences (6.5%) were found in 11 patients, 10 of 12 occurred within the first year after operation. After each surgeon's 20th hernioplasty the recurrence rate was 3 of 113 hernioplasties (2.6%) (p < 0.05). Late local pain around the patch and its staples was found in 12 patients, slight in 10 cases, mild in 1 case and serious in 1 case. Local hypoesthesia of the upper internal part of the thigh was found in one patient. Not any testicular atrophy, nor intraperitoneal complications were observed. This study suggests that: 1) the 2-year recurrence rate of intraperitoneal ePTFE hernioplasties is not very different, after the learning phase, from those of many other procedures; 2) their expensive price lead to use these techniques only when other efficient procedures are not feasible, for example in the challenged treatment of recurrent hernia after failure of a preperitoneal prosthetic hernioplasty.