The laparoscopic transabdominal preperitoneal and total extraperitoneal inguinal hernioplasty: advantages and shortcomings

Nowadays, the issue of choosing the mode of hernioplasty of inguinal hernia is to be actual. The proposed multiple alternatives of reconstruction of anterior or posterior walls of inguinal canal using local tissues are not quite effective ones. The reason is that under primary inguinal hernia relapses occur with rate of 10-30% and especially in case of such complex forms of inguinal hernia as sliding, combined, giant, relapsing and repeatedly relapsing. The number of relapses make up to 40-45%. The nonstrain modes of inguinal hernioplasty using mesh alloprothesis decreased rate of relapses up to 1-5%. However, aggression of operation, possibility of development of chronic pain syndrome and long term of physical and psychological rehabilitation served as an occasion for developing mini-invasive techniques of surgery. During last 15 years the laparoscopic techniques of surgery are applied in surgical practice. The laparoscopic transabdominal and preperitoneal and total extraperitoneal inguinal hernioplasties combine mini-invasive access and nonstrain prosthetics of posterior wall of inguinal canal. the both techniques are effective in view of decreasing of aggression of operative intervention, amelioration of aesthetic results and decreasing relapses up to 2% in case of both techniques. However, the well-formulated criteria of choice of laparoscopic technique are absent. There is not enough data concerning comparative results of treatment in remote post-operative period.

laparoscopic inguinal hernioplasty, transabdominal preperitoneal hernioplasty, total extraperitoneal hernioplasty