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

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2. 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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3. 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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