Laparoscopic Inguinal Hernia Repair (TAPP Technique)
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 swelling (painful or painless) in the inguinal regions (right or left).
Under normal circumstances, small anatomical openings exist; when these widen, an intra-abdominal organ (usually bowel or omentum) may protrude, producing 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 activities, persistent coughing, or difficulty in urination
When the pain does not subside, urgent surgical evaluation by a specialist surgeon is required, with the possibility of emergency intervention to prevent progression even to peritonitis. This condition is known as incarcerated inguinal hernia.
EVERY patient diagnosed with an inguinal hernia must undergo surgery—electively, or urgently in the case of incarceration.
The laparoscopic inguinal hernia repair using the TAPP technique is performed under general anesthesia.
Through three small incisions in the anterior abdominal wall, access is gained to the peritoneal cavity. A full abdominal laparoscopy is performed, and adequate working space is created by mobilizing the peritoneum.
The hernia sac is identified, reduced, and a sufficiently large mesh is placed to cover all hernia sites (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 return to daily activities
• Possible development of adhesions
In cases of incarceration or difficulty in reducing an inguinal hernia, this technique is considered the method of choice.
SPECIALIZED surgical training is REQUIRED, and standard laparoscopic instruments are used because the working space is larger.
