LAPAROSCOPIC INGUINAL HERNIA REPAIR Procedure MICHAEL GENITSARIS MD

LAPAROSCOPIC INGUINAL HERNIA REPAIR ΤΑΡΡ Procedure MICHAEL GENITSARIS MD GENERAL SURGEON International Interbalkan Medical Center THESSALONIKI GREECE

RECURRENCE CAUSES n n n MISSED HERNIAS (Femoral Hernias) TENSION MALL TECHNICAL PRAKTISE

RECCURENCE RATE n POSTERIOR APPROACH (Stoppa, Nyhus) Ø n Recurrence rate< 4% Tension free (mesh implantation) (Lichtenstein) Ø Recurrence rate 0. 77%

LAPAROSCOPICAL APPROACH

LAPAROSCOPICAL REPAIR TAPP mesh implantation n n Recurrence rate 0. 7 – 2 % TEP considered development of TAPP

FELIX CRITERIA TAPP Routine Previous abdomen operations Bilateral hernia Huge inguinal hernia Incarcerated Recurrence TEP √ √ ν √ √ √

ΤΑΡΡ COMPLICATIONS n n n n Small bowel obstruction due to in a peritoneal gap entrapment Scrotum hygroma or haematoma Neuralgia of the thigh Epigastric vessels damage Bladder damage Orchitis Mesh inflammation

LAPAROSCOPIC INGUINAL HERNIA REPAIR ADVANTAGES n n n n Better inner inguinal wall approach. Laparoscopic mesh implantation covers all defective points of the inner inguinal canal. Tension-free procedure. Minimal post operation pain. Few days recovery time. Few percentage of recurrence rate. Few complications

DISADVANTAGE of the PROCEDURE High learning curve