Complete extraperitoneal hernia repair-TEP, does not enter the patient’s abdominal cavity, and one patch can cover the location where various hernias such as hiatal hernia, straight hernia, femoral hernia, etc. have occurred, one treatment over, solving all problems, very low recurrence rate after surgery, no abdominal adhesions, outstanding advantages! Now the first choice for hernia treatment! Hernia is a common surgical disease. It is generally known as extra-abdominal hernia in medicine, and its types include inguinal hernia, incisional hernia, umbilical hernia and femoral hernia. And among them, inguinal hernia is the most common type of extra-abdominal hernia, which is divided into hiatal hernia, straight hernia and femoral hernia. It is characterized by a painless or distended lump in the left or right inguinal region, which is more obvious when upright and shrinks or even disappears when lying down. The substance is a protrusion of intra-abdominal organs from a weak defective area of the abdominal wall, resulting in a reproducible mass. The disease can develop at any age, with more men than women and more older than younger patients. There are congenital and acquired factors in the formation of inguinal hernia. Most of the young patients are caused by congenital factors, such as the descent of the testes to the scrotum during fetal life, and if the canal is not completely occluded, the organs in the abdominal cavity may protrude through the inguinal canal and form a hernia when they grow up. There are also causes such as congenital defects in the local abdominal wall. In addition to congenital factors, acquired factors are the main reasons for the development of hernia in elderly patients, such as muscle atrophy, loosening of muscle tissue, or increased pressure in the abdominal cavity caused by constipation or prostatic hypertrophy that makes large and small stools unstable.
Most patients tend to disregard the newly occurred inguinal hernia because the discomfort symptoms are not obvious, and think that no treatment is needed. In fact, this is a rather wrong viewpoint, because if a new inguinal hernia is not treated in time, the original abdominal wall defect will become larger and larger, causing difficulties in treatment, and in addition, the recurrence rate increases after treatment. As the hernia increases in size, the symptoms of distension and discomfort become more pronounced, affecting the quality of life. In severe cases, there is also a retrievable mass that cannot be pushed back into the body, accompanied by abdominal cramps, vomiting and abdominal distension, which indicates that the protruding intestinal cavity or other intra-abdominal organs are stuck in the hernia ring and can no longer be retrieved into the abdominal cavity, which is medically called hernia entrapment, which can easily lead to ischemia and necrosis of the intestinal cavity or other intra-abdominal organs and can be life-threatening if not operated in time. Except for a small number of hernia in young children, hernias require surgical treatment. The purpose of surgery is to repair and strengthen the abdominal wall defects and weaknesses so that the abdominal organs no longer protrude. There are many methods of hernia repair. The earliest classical hernia repair, in which the tissue on both sides of the defect is forcibly sutured, has high tension, and the patient feels discomfort from the pulling at the wound for a longer time after surgery, and has a high recurrence rate of up to 10%-30%. Therefore, it is gradually replaced by tension-free hernia repair with open artificial mesh filling, which has greatly reduced the recurrence rate. In recent years, with the improvement of medical devices and surgical techniques, laparoscopic surgery has made significant progress and laparoscopic hernia repair, like other laparoscopic surgeries, has evolved tremendously. The human abdominal wall is divided into several layers, with the innermost layer called the peritoneum. The impact on the person can be much less if the surgery can be performed without entering the abdominal cavity for treatment purposes. Laparoscopic total extraperitoneal repair (TEP for short) can do this with only two 5 mm and one 10 mm wounds, without entering the abdominal cavity and completely outside the peritoneum, by pulling the hernia pouch back into the abdominal cavity and covering the herniated gap with artificial mesh, according to the endoscopic TV images. The advantages of this method are as follows: firstly, since it is performed completely extraperitoneally, it does not touch the intra-abdominal organs and does not produce abdominal adhesions; secondly, since the artificial mesh repair is performed at the weakest point, the artificial mesh does not require sutures and can quickly fuse with the abdominal wall tissue to form a highly tension-resistant union, and since the patch placed is 10×15 cm in size, it can cover hiatus, hiatal and femoral hernias at the same time The recurrence rate is low, usually around 1%, and can be further reduced to 0.1% by surgeons with extensive laparoscopic experience. Because of the smaller wound, the postoperative pain is light, the discomfort reaction is small, the recovery is fast, the chance of wound infection is low, and the patient can go home for daily life on the second day after surgery and can return to work 1 to 2 weeks after surgery. In addition, laparoscopic total extraperitoneal repair is most suitable for bilateral inguinal hernias and recurrent hernias. Because of the advantages of less trauma, faster recovery and lower recurrence, and because the cost of treatment is comparable to that of open artificial mesh repair, this procedure has been accepted by more and more patients, but total extraperitoneal hernia repair is technically challenging and requires a surgeon with extensive experience in laparoscopic surgery to perform this procedure.