Laparoscopic Inguinal Hernia Repair: TEP
Laparoscopic approach to inguinal hernia involves access to the preperitoneal space without reaching the intraperitoneal compartment and, thus, without any disadvantages that ensue, such as the possibility of injury to viscera or postoperative paretic ileus. This path improves patient comfort by reducing pain after surgery and time off work. However, the main drawback is the difficulty of learning the technique. It is essential that surgeons performing this procedure complete a minimum of 25–50 tutored laparoscopic hernia repairs to be considered as having completed the learning phase.
Since performing a laparoscopic hernioplasty involves access to preperitoneal space, reducing the hernia sac, and placing a prosthesis, the approach to the preperitoneal space can be done by total extraperitoneal (TEP) or transabdominal preperitoneal access (TAPP).
Currently, it is accepted that TEP is preferred over TAPP because the TEP technique can result in lower trocar-site hernias and intra-abdominal injuries. However, TEP is a more demanding and complex technique, with a higher learning curve. The main technique in the learning curve in laparoscopic inguinal hernia repair should be the TAPP intervention as first recourse. After mastering the TEP intervention, performing a TAPP intervention will seem easy.
KeywordsLaparoscopy Hernia Hernioplasty Mesh Inguinal TAPP TEP Fixation
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