Technique: Laparoscopic TAPP and IPOM

Abstract

Laparoscopic inguinal herniorrhaphy provides a posterior reinforcement of the myopectineal orifice. The established indications for a laparoscopic repair include bilateral defects and recurrent hernias following an anterior approach. The transabdominal preperitoneal (TAPP) technique and the intraperitoneal onlay mesh (IPOM) procedure both utilize a transabdominal approach, which provides excellent visualization of both inguinal regions. Once proficiency in the technique is achieved, the recurrence rates are comparable to all open mesh repairs. The laparoscopic approach minimizes dissection and potential damage to the sensory nerves in the groin. Arguably, there is less postoperative pain and earlier return to activity. More promising is the prospect of reducing chronic, post-herniorrhaphy inguinodynia, which is under appreciated. For this reason, all patients should be considered for a laparoscopic repair.