Why from the inside during a relapse
Repeated incision through the scar is dangerous for the spermatic cord and is associated with a high frequency of new relapses - laparoscopic preperitoneal access bypasses the area of the previous operation: the surgeon sees the true defect (often the hernia comes out next to the previous repair), completely covers the posterior wall with a larger mesh with reliable fixation. Relapses after such repeated plastic surgery are 2–3%. The reverse logic also works: a relapse after laparoscopy is operated on openly - the “change of floor” principle. Recovery is the same as during the primary operation.
Indications
- an inguinal hernia of any size is a planned operation (hernias cannot be cured without surgery and threaten strangulation);
- bilateral hernias - simultaneous repair on both sides during one anesthesia;
- relapse after open surgery - laparoscopic access using a “fresh” method;
- combination with other laparoscopic operations.
TAPP and TEP techniques
During laparoscopic hernioplasty, a mesh implant is installed from the inside on the posterior wall of the inguinal canal, immediately closing all weak areas (oblique, direct, femoral hernia): TAPP - through the abdominal cavity with suturing of the peritoneum over the mesh, TEP - preperitoneal without entering the abdomen. The 10x15 cm mesh is fixed hermetically, grows in and creates a strong frame; relapses - 1–2%. Advantages over open repair: less chronic pain (nerves do not get into the suture), quick return to activity, cosmetic benefits, ability to close both sides through the same punctures. The cost of the mesh implant is included in the price list.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
