ABSTRACT
The first laparoscopic hernia repair was performed prior to laparoscopic cholecystectomy, yet has not supplanted open hernia repair, as has laparoscopic cholecystectomy for gallbladder disease. Reasons may include a steeper learning curve, an assumed increased operative cost, and the excellent alternative in open hernia repair. Ger in 1982 reported on 13 patients undergoing hernia repair, using a stapling device; the 13th patient underwent a laparoscopic repair (1). This early technique used a stapling device to close the neck of the hernia as the sole repair. Since then various techniques have been devised for laparoscopic herniorrhaphy. The initial approach consisting of simple ring closure had a high failure, because the deeper tissues were not approximated. This evolved to the necessity of a prosthetic biomaterial to reinforce the defect. Bogojavalensky first introduced hernia repair using a biomaterial in 1989 (2). At that time, a rolled piece of polyprolene mesh was placed into the indirect space of the hernia. Preliminary reports of this technique were promising, but long-term follow-up revealed a recurrence rate of 15% to 20%, leading to abandonment of such technique. Subsequently, the plug-and-patch and then the development of the intraperitoneal onlay mesh followed.
