%0 Journal Article
%T Herniorrafia inguinal laparosc車pica totalmente extraperitoneal: vinte e sete complica  es graves ap車s 4565 opera  es consecutivas Laparoscopic totally extraperitoneal inguinal hernia repair: twenty-seven serious complications after 4565 consecutive operations
%A Alberto Meyer
%A Pierre Blanc
%A Jean Gabriel Balique
%A Masaya Kitamura
%J Revista do Col谷gio Brasileiro de Cirurgiˋes
%D 2013
%I Col谷gio Brasileiro de Cirurgi?es
%X OBJETIVO: identificar e avaliar as complica  es do tratamento da h谷rnia inguinal com a coloca  o de tela totalmente extraperitoneal. M谷TODOS: Foram inclu赤dos, em uma s谷rie consecutiva de 4565 reparos de h谷rnia laparosc車pica, pacientes que haviam sido submetidos ao procedimento TEP entre janeiro de 2001 e janeiro de 2011. Os crit谷rios de inclus o foram: diagn車stico com h谷rnia inguinal sintom芍tica, incluindo recorr那ncia ap車s corre  o de h谷rnia inguinal e cirurgia pr谷via em abd men inferior e pelve. Todos os pacientes > 18 anos de idade. Pacientes com h谷rnia encarcerada na urg那ncia foram exclu赤dos do estudo. RESULTADOS: Um total de 4565 h谷rnias foram inclu赤das no estudo. Ocorreram 27 complica  es graves (0,6%): 12 hemorragias (0,25%), duas les es da bexiga (0,04%), cinco oclus es (0,11%), quatro perfura  es intestinais (0,09%), uma les o da veia il赤aca (0,02%), uma les o do nervo femoral (0,02%), duas les es dos vasos deferentes (0,04%) e dois 車bitos (0,02%) (embolia pulmonar, peritonite). CONCLUS O: A taxa de complica  es com o procedimento TEP 谷 baixa. Corre  o de h谷rnia laparosc車pica 谷 uma t谷cnica reprodut赤vel e confi芍vel. Em nossa experi那ncia, existem contraindica  es para o procedimento de TEP. A t谷cnica TEP deve ser minuciosa para evitar complica  es intraoperat車rias (diatermia bipolar). As complica  es podem ocorrer mesmo ap車s o cirurgi o ter adquirido experi那ncia substancial. OBJECTIVE: To identify and assess the complications of laparoscopic inguinal hernia treatment with totally extraperitoneal mesh placement (TEP). METHODS: We included patients who had undergone the TEP procedure in a consecutive series of 4565 laparoscopic hernia repairs between January 2001 and January 2011. Inclusion criteria were diagnosis with symptomatic inguinal hernia, including recurrence after inguinal hernia repair and previous surgery in the lower abdomen and pelvis. All patients were 18 years of age or above. Patients with incarcerated hernia in emergency were excluded from the study. RESULTS: A total of 4565 hernias were included in the study. In the group, there were 27 severe complications (0.6%): 12 bleedings (0.25%), two bladder lesions (0.04%), five intestinal obstructions (0.11%), four intestinal perforations (0.09%) one injury to the iliac vein (0.02%), one femoral nerve injury (0.02%), two lesions of vas deferens (0.04%) and two deaths (0.02%) (pulmonary embolism, peritonitis). CONCLUSION: The rate of complications with the TEP procedure is low. Laparoscopic hernia repair technique is reproducible and reliable. In our experience, there are contraindications
%K H谷rnia Inguinal
%K Procedimentos cir迆rgicos operat車rios
%K Laparoscopia
%K Herniorrafia
%K Complica  es p車s-operat車rtias
%K Inguinal Hernia
%K Operative surgical procedures
%K Laparoscopy
%K Herniorrhaphy
%K Complications after operat車rtias
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912013000100006