Laparoscopic Totally Extraperitoneal Hernia Repair (TEP)

Laparoscopic Inguinal Hernia can be performed by two ways, either TEP or TAPP. Two revolutions in inguinal hernia repair surgery have occurred during the last two decades. The first was the introduction of tension-free hernia repair by Liechtenstein in 1989 and the second was the application of laparoscopic surgery by Ger to the treatment of inguinal hernia in the early 1990s.

The assess the safety and effectiveness of laparoscopic totally extra-peritoneal (TEP) repair is already established and there are many studies to discuss the technical changes that surgeon faced on the basis of thier accumulative experience. Patients who underwent an elective inguinal hernia repair at the Department of Abdominal Surgery at the World Laparoscopy Hospital, Dr Mishra, between January 1999 and July 2005 were enrolled retro- spectively in this study. Patient demographic data, operative and postoperative course, and outpatient follow-up were studied.

When performed by a surgeon with experience in hernia repair, laparoscopic repair results in fewer complications than Liechtenstein, particularly less chronic pain.

However, if the surgeon has experience in general laparoscopic surgery, but not the specific topic of laparoscopic hernia surgery, laparoscopic repair is not recommended, because it causes the risk of recurrence of Liechtenstein, while the risk of serious complications, such as organ damage. In fact, the TAPP approach should go through the stomach. That said, many surgeons are moving to laparoscopic methodologies such as the cause of smaller incisions, resulting in less bleeding, less infection, faster recovery, reduced hospitalization and reduced chronic pain.

There is no difference between the cost of laparoscopic and open repair increased operating expenses offset by a decrease in the recovery period. The level of return identical when laparoscopy is performed by an experienced surgeon. When performed by a surgeon with less experience in the tower repair of inguinal hernia, the return is higher than after Liechtenstein.

Complications

Complications are common (> 10%). They include, but are not limited to foreign body sensation, chronic pain, ejaculation disorder, collapsible mesh net migration (meshoma) infection, adhesion formation, erosion d intraperitoneal organs. These complications usually become apparent weeks or years after the initial correction is introduced as abscess, fistula or intestinal obstruction.

Finally, polypropylene networks face degradation due to the effects of heat. This increases the risk of stiffness and chronic pain. Persistent inflammation and increased cellular traffic to interface the mesh fabric raised the possibility of malignant transformation.

If obstructive Azoospermia associated with polypropylene mesh used, due to obstruction of the vas deferens due to fibroblastic reaction network. However, a recent study showed that the risk appears to be less than 1%, and therefore does not need to be informed consent.