[Celioscopic treatment of recurrence of inguinal hernia after insertion of a prosthesis. Value of the intraperitoneal technique with ePTFE patch? Group CHIC (Cure des Hernies Inguino-Crurales sous Coelioscopie)]

Abstract

From April 1993 to December 1994, 14 failures of classic prosthetic herniorraphies in 13 patients (13 men) were treated by a laparoscopic intraperitoneal onlay mesh technique (IPOM) using an ePTFE patch. The mean age of these patients was 55.69 +/- 13.11 years (28 to 70). The mean operating time was 72.5 +/- 24 mn (40 to 120). The technique could not be performed in one case. The mean postoperative pain at D1, evaluated by a visual analog scale graduated from 0 to 10 was 2.36 (2 to 3). The mean hospital stay was 1.64 days (1 to 3). One inguinal hematoma occurred and resolved after a short incision. The mean time to return to work or normal activity was 12.14 +/- 7.25 days (3 to 30). All patients were reviewed. The mean follow-up was 13.37 +/- 2.87 months (6 to 25). No testicular atrophy was observed. One recurrence occurred at M6 treated at M9 by an open procedure. Our study suggests that this technique, avoiding extensive preperitoneal dissection, thus decreasing vascular and genital risks, would be useful in the treatment of failures of prosthetic herniorraphies.