Endovideogernioplasty in patients with inguinal hernias: advantages and disadvantages

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Abstract

This study analyzed the results of treatment of patients with inguinal hernias, with an assessment of the advantages and disadvantages of endovideosurgical hernioplasty techniques. The clinical study used the data of 1317 patients with inguinal hernias. The results revealed that the totally extraperitoneal inguinal hernia repair had some advantages over laparoscopic hernioplasty, such as a shorter duration of surgery (43 ± 15 min), mild pain on a visual analog scale, and an average bed-day after surgery. Complications were diagnosed in 16 (1.2%) patients, and most had Clavien–Dindo grade II complications. Relapses were detected in 7 (0.5%) cases. Thus, endoscopic hernioplasty (laparoscopic and totally extraperitoneal inguinal hernioplasty) was the preferred surgery for patients with bilateral inguinal hernia, recurrent hernia after traditional hernioplasty, and metabolic syndrome and young people of working age. The use of a modified technique of totally extraperitoneal inguinal hernioplasty with a clear understanding of the multifascial structure of the anterior abdominal wall may reduce the risks of both intraoperative and postoperative complications and increase the cost-effectiveness of treatment of patients with inguinal hernias, allowing us to obtain good results.

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About the authors

Pavel N. Romashchenko

Military Medical Academy named after S.M. Kirov of the Ministry of Defence of the Russian Federation

Email: romashchenko@rambler.ru
ORCID iD: 0000-0001-8918-1730
SPIN-code: 3850-1792

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Alexander A. Kurygin

Military Medical Academy named after S.M. Kirov of the Ministry of Defence of the Russian Federation

Email: kurygin60@gmail.com
ORCID iD: 0000-0003-2617-1388
SPIN-code: 3446-1971

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Valery V. Semenov

Military Medical Academy named after S.M. Kirov of the Ministry of Defence of the Russian Federation

Email: semvel-85@mail.ru
ORCID iD: 0000-0003-1025-332X
SPIN-code: 1481-2595

candidate of medical sciences

Russian Federation, Saint Petersburg

Alexey A. Mamoshin

419th military hospital of the Ministry of Defense of the Russian Federation

Author for correspondence.
Email: aleksej0191@mail.ru
ORCID iD: 0000-0002-7663-5120
SPIN-code: 5959-4360

resident

Russian Federation, Novorossiysk

References

  1. Burdakov VA, Zverev AA, Makarov SA, et al. Endoscopic extraperitoneal approach in the treatment of patients with primary and postoperative ventral hernias. Endoscopic Surgery. 2019;25(4):34–40. (In Russ.). doi: 10.17116/endoskop20192504134
  2. Egiev VN, Voskresensky PK. Gryzhi. Moscow: Medpraktika-M; 2015. P. 48–54. (In Russ.).
  3. Yemelyanov SI, Protasov AV, Rutenburg GM. Endoskopicheskaya hirurgiya pahovyh i bedrennyh gryzh. Saint Petersburg: Foliant; 2000. P. 123–128. (In Russ.).
  4. Kurygin AA, Romashchenko PN, Semenov VV, Polushin SYu. Laparoscopic elimination of large strangulated umbilical hernia and hernia of the white line on the IPOM technique. Grekov's Bulletin of Surgery. 2018;177(4):73–75. (In Russ.). doi: 10.24884/0042-4625-2018-177-4-73-75
  5. Prudnikova EA. Alibegov RA. Inguinal hernia: modern methods of the plastic arts. Vestnik Smolenskoy Gosudarstvennoy Medicinskoy Akademii. 2010;9(4):104–107. (In Russ.).
  6. Romashchenko PN, Kurygin AlA, Semenov VV, et al. Justification and direct results of endoscopic gynryoplastics with TAPP and TEP techniques. Bulletin of the Russian Military Medical Academy. 2019;21(1):125–129. (In Russ.). doi: 10.17816/brmma13064
  7. Romashchenko PN, Fomin NF, Maistrenko NA, et al. The topographical, anatomical and clinical substantiation of total extraperitoneal inguinal hernioplasty. Endoscopic Surgery. 2020;26(5):16–23. (In Russ.). doi: 10.17116/endoskop20202605116
  8. Romashchenko PN, Kurygin AlA, Semenov VV, et al. Avantazh endoskopicheskih metodik TAPP i TEP u bol'nyh pahovymi gryzhami. Al'manah Instituta hirurgii im. AV. Vishnevskogo. 2019;1:94–95. (In Russ.).
  9. Sazhin AV, Klimiashvili AD, Kochiay E. The technical characteristics and immediate results of laparoscopy trans-peritoneal and total extra-peritoneal hernioplasty. Medical Journal of the Russian Federation. 2016;22(3):125–128. (In Russ.). doi: 10.18821/0869-2106-2016-22-3-125-129
  10. Semenov VV, Kurygin AA, Romashchenko PN, et al. Endovascular treatment of patient with strangulated Amyand’s hernia. Vestnik khirurgii im. I.I. Grekova. 2017;176(2):112–114. (In Russ.). doi: 10.24884/0042-4625-2017-176-2-112-114
  11. Tareneckij AI. Topograficheskoe opisanie sobstvenno podchrevnoj oblasti zhivota (Regio hipogastrica propria): [Dissertation] St. Petersburg: 1874. 56 p. (In Russ.). Available from: https://rusneb.ru/catalog/000200_000018_v19_rc_1640593/
  12. SHareckij BG. Topografo-anatomicheskij ocherk region subumbilicalis. Har'kov: Pechatnik; 1912. 124 p. (In Russ.).
  13. Ansari MM. Rectusial Fascia: A New Entity of Laparoscopic Live Surgical Anatomy. Open Access J Surg. 2017;3(4):555–618. doi: 10.19080/OAJS.2017.03.555618
  14. Ansari MM. Surgical preperitoneal space: holy plane of dissection between transversalis fascia and preperitoneal fascia for TEPP inguinal hernioplasty. MOJ Surg. 2018;6(1):26–33. doi: 10.15406/mojs.2018.06.00119
  15. Belyanskу I, Daes J, Radu VG, et al. A novel approach using the enhanced — view totally extraperitoneal (eTEP) technique for laparoscopic retromuscular hernia repair. Surg Endosc. 2018;32(3):1525–1532. DOI: 10.1007%2Fs00464-017-5840-2
  16. Bittner R, Montgomery MA, Arregui E, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia. International Endohernia Society Surgical Endoscopy. 2015;29(2):289–321. doi: 10.1007/s00464-015-4156-3
  17. Elhendawy AO, Abd-Raboh OH, et al. Randomized Comparative Study Between Laparoscopic Transabdominal Pre-Peritoneal Versus Totally Extraperitoneal Approach in Inguinal Hernia Repair. Advances in Surgical Sciences. 2018;6(1):1–6. doi: 10.11648/j.ass.20180601.11
  18. Fersli GS, Massad A, Albert P. Extraperitoneal endoscopic inguinal hernia repair. J Laparoendosc Surg. 1992;2(6):281–286. doi: 10.1089/lps.1992.2.281
  19. Gupta S, Goyal S, Sharma R, Attri AK. Lichtenstein repair using lightweight mesh versus laparoscopic total extraperitoneal repair using polypropylene mesh in patients with inguinal hernia: A randomized study. Saudi Surg J. 2019;7:148–153. doi: 10.4103/ssj.ssj_27_19
  20. Kockerling F, Bittner R, Jacob DA, et al. TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surgical Endoscopy. 2015;29(12):3750–3760. doi: 10.1007/s00464-015-4150-9
  21. Lomanto D, Sta. Clara EL. Total Extraperitoneal (TEP) Approach in Inguinal Hernia Repair: the Old and the New. Inguinal Hernia Surgery. 2017;115–129. doi: 10.1007/978-88-470-3947-6_12
  22. McKernan JB. Extraperitoneal prosthetic inguinal hernia repair using an endoscopic approach. Int Surg. 1995;80(1):26–28.

Supplementary files

Supplementary Files
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1. Fig. 1. . Scheme of installation of trocars for the elimination of bilateral (a) and right-sided (b) inguinal hernia according to the TEP method: 1 — optical trocar, 10 mm; 2 — 10-mm trocar; 3 — 5-mm trocar for working tools

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2. Fig. 2. . Scheme of the layered structure of the anterior abdominal wall with the zone of correct installation of the mesh prosthesis (between the transverse and preperitoneal fascia): 1 — upper anterior spine of the ilium; 2 — pubic bone; 3 — lower epigastric vessels; 4 — lower edges of the internal oblique and transverse abdominal muscles; 5 — aponeurosis of the external oblique abdominal muscle; 6 — mesh implant; 7 — peritoneum; 8 — interfacial fat space; 9 — transverse fascia; 10 — preperitoneal fascia

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Copyright (c) 2021 Romashchenko P.N., Kurygin A.A., Semenov V.V., Mamoshin A.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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