There are various types of hernias of the abdominal wall. The most common is the inguinal hernia (more frequent in men).
An inguinal hernia is the appearance of a swelling (painful or painless) in the inguinal regions (right or left).
Under normal conditions, small anatomical openings exist; when these widen, an intra-abdominal organ (most commonly bowel or omentum) may protrude, resulting in symptoms.
Symptoms of an inguinal hernia:
• Swelling in the area (small or large), which varies with increases in intra-abdominal pressure
• Pain that worsens as the day progresses, with athletic activity, persistent coughing, or difficulty in urination
When the pain does not subside, urgent surgical assessment by a specialist surgeon is required, with the possibility of emergency intervention to prevent progression even to peritonitis. This condition is called incarcerated inguinal hernia.
EVERY patient diagnosed with an inguinal hernia must undergo surgery—electively, or urgently if incarceration is present.
The laparoscopic inguinal hernia repair using the TEP technique is performed under general anesthesia.
Through three small incisions in the anterior abdominal wall, access is gained to the preperitoneal space (without entering the peritoneal cavity). Adequate working space is created, with or without the use of a specialised laparoscopic instrument.
The hernia sac is identified, reduced, and a sufficiently large mesh is placed to cover the areas where hernias develop (direct, indirect, and femoral). The mesh is secured with a fixation device, biological glue, or left unsecured.
The mesh is completely inert to the body, preventing mesh-related complications.
Advantages of this technique:
• Minimal or absent postoperative pain
• Rapid mobilization of the patient
• Early resumption of daily activities
• Avoidance of adhesions
SPECIALIZED surgical training is REQUIRED, along with the availability of specific laparoscopic instruments, because the working space is very limited. In addition, the hernia must be reducible.
