Laparoscopic surgery for groin hernia in a third world country: a report of 9 cases of transabdominal pre-peritoneal (TAPP) repair in Yaoundé, Cameroon

Abstract

Groin hernia repair is probably the most common procedure in general surgery. Today, in adult hernias, prosthetic repairs are accepted to be superior to "non-mesh" suture repairs. Concerning mesh repair, the (open) LICHENSTEIN and laparoscopic inguinal hernia techniques are recommended as the best evidence-based options. Nevertheless laparoscopic repair techniques still not currently practiced in sub-Saharan countries and particularly in Cameroon. From January 2011 to November 2014, a prospective laparoscopic groin hernia-specific database was queried for all adult patients in the visceral and laparoscopic surgery unit of the National Insurance Health Center of Essos (Yaoundé/Cameroon). Seven patients were recorded. All of them were male with a mean age of 49 years. Two cases were bilateral, 5 unilateral and all of them primary. There were 6 direct and 3 indirect hernias. They underwent 9 Transabdominal Pre-peritoneal (TAPP) repair and none Totally Extra-Peritoneal (TEP) procedure was done. A self-gripping overlapping flap was inserted in all cases. The mean length of the procedure was decreasing with time, from 150 min for our first procedure to 60 minutes for the last one. With a mean follow-up period of 20.2 months, the post-operatives courses were uneventful. Laparoscopic hernia repair in general and TAPP in particularly is a safe and reproducible procedure even in developing countries. African surgeons should be aware of this technique.

Pan African Medical Journal 2016; 23