What is laparoscopic inguinal hernia repair?

Hernia is a very common disease, but many patients lack of awareness of this disease, not only do not timely diagnosis and treatment, but also try to believe in small advertisements, thinking that eating unnamed injections can be cured. In fact, surgery is the only reliable way to cure inguinal hernia in adults. Hernia, commonly known as “small bowel string gas”, is a part of the body tissue or organ left the original site, through the body gap, defects or weak parts into another part. Hernia is one of the most common surgical diseases, and inguinal hernia is the most common hernia. The formation of hernia has a lot to do with the patient’s physique, mostly due to coughing, sneezing, overexertion, overfatting of the abdomen, degenerative lesions of the abdominal wall strength in old age, and so on. Patients often delay treatment because of some misunderstandings, these misunderstandings are mainly the following: 1, it does not matter to the hernia. Some people think that hernia does not hurt, does not delay eating and drinking, do not need treatment. Do not realize that with the prolongation of the condition, the hernia will become larger and larger. Once incarcerated, intestinal necrosis and other life-threatening. 2, do not know the formal treatment method. Some patients are either induced by false advertisements or hope for conservative treatment. In fact, any unnamed object or hernia belt cannot treat hernia. Many patients who have failed injection treatment will also increase the difficulty of surgery. Conservative treatment can only temporarily relieve the symptoms, hernia is a physical defect of the abdominal wall, surgery is the only treatment. 3, fear of surgery, fear of anesthesia, fear of bed-ridden unattended after surgery. Nowadays, most of the surgery is laparoscopic minimally invasive surgery, no incision, commonly known as “eye” surgery, the patient can be discharged from the hospital one day after surgery. 4. Fear of recurrence. With the application of new laparoscopic technology, the postoperative recurrence rate has been reduced from the original 20%D30% to the current 1% or so. The only way to truly treat hernia is to take hernia surgery. Transabdominal preperitoneal repair (transabdominal preperitoneal , TAPP) , is currently the most widely used type of laparoscopic inguinal hernia repair, the operation in the abdominal cavity to cut the inguinal area of the peritoneum, separation of the hernia sac, the peritoneum and all the fatty tissues underneath it, to reveal the structures in the inguinal area, including the Cooper’s ligament, the blood vessels of the abdominal wall, the spermatic cord or the round ligament, the rectus abdominis muscle. round ligament, the outer edge of the rectus abdominis muscle, and the inguinal ligament. An appropriately sized patch is implanted into the separated preperitoneal space, and the periphery of the patch is stapled to the rectus abdominis muscle, abdominal wall, inguinal ligament, and ligament of Cooper with a stapling device, or, in some cases, with bioadhesive, and the separated peritoneal rims are sutured or stapled in situ so that the patch is completely covered by the peritoneum. Totally extraperitoneal (TEP) is performed in much the same way as TAPP. However, this method does not require entry into the abdominal cavity, which reduces interference with the abdominal cavity and intestinal adhesions. However, due to the artificial cavity, the operation space is small, the anatomical level is not easy to be clear, and requires experienced surgeons to complete, while TEP has the least interference with the abdominal cavity and basically does not cause abdominal adhesions. TEP does not cause postoperative abdominal adhesions, with the skill of laparoscopic operation and the development of machinery, TEP is respected by more and more physicians. The benefits of laparoscopic hernia repair in terms of cosmesis, mild postoperative pain, no restriction of activity, and the ability to go to work early, far outweigh the extra portion of the hospitalization costs that they pay. There are several randomized controlled studies comparing the results of different laparoscopic repairs (TAPP and TEP) with a variety of different open patch repairs to study the different clinical outcomes of TAPP and TEP. It was concluded that laparoscopic surgery is an optional surgical procedure for inguinal hernia repair. Although laparoscopic hernia repair has a relatively long learning curve and is more expensive than open surgery in terms of operative time and cost, the advantages, in addition to mild postoperative pain and rapid recovery, are that for bilateral hernias and inguinal hernias combined with celiac disease, laparoscopic hernia repair can be accomplished without another incision or additional operative holes, with no increase in the rate of recurrence, and there is no difference in the time of recovery; and in the case of recurrent hernias, the absence of the need to enter from the original approach reduces the possibility of damage to the spermatic cord and nerves and the possibility of injury to the spermatic cord and nerves, and there are no differences in clinical outcomes between TAPP and TEP. For recurrent hernias, the possibility of damage to the spermatic cord and nerves is reduced because it is not necessary to enter through the original approach, and the recurrence rate is not higher than that of open surgery; especially for children, the spermatic cord will not be damaged due to anatomical ambiguity; TAPP has the advantage of detecting contralateral occult hernias during the operation, and the data statistics show that 20-30% of patients with primary unilateral hernias subsequently form hernias in the contralateral side, which demonstrates the importance of intraoperative exploration. We now use a staple-free technique for fixation of the patch, using bioprotein adhesive to fix the patch, which greatly reduces chronic postoperative pain due to irritation and damage to the nerves of the inguinal region. Therefore, current evidence suggests that laparoscopic surgery should be performed as a routine procedure, and experts recommend that ventral hernia surgical treatment should always be performed by a hernia surgeon who is experienced in laparoscopic operations and specializes in hernia surgery, in order to reduce the incidence of serious intra-operative complications and to effectively reduce the cost (especially to reduce the use of disposable instruments), and there is no doubt that, with the development of laparoscopic technology, the improvement of surgical instruments, and the advancement of hernia repair materials, the There is no doubt that with the development of laparoscopic technology, the improvement of surgical instruments, and the advancement of hernia repair materials, laparoscopic hernia repair will have a good development and application prospect.