A FEATURE OF LAPAROSCOPIC TREATMENT OF IRREDUCIBLE AND LARGE INGUINAL HERNIAS

Abstract

Summary. Introduction. The inguinal hernia is one of the most common surgical problems around the world. Patients with large inguinal and inguinal hernias are a certain group. At present, there are no final convincing evidence of the advantage of laparoscopic hernia repair of complex forms of inguinal hernias, indications and contraindications to various methods of this operation, the technology of performing surgical interventions for various types of complex inguinal hernias has not been completed.
 Aim. Perform perioperative complications in surgical treatment of unrecognizable and large inguinal hernias with laparoscopic modified TAPP method, classic Laparoscopic TEP laparoscopic technique and inguinal canal plastic according to Lichtenstein.
 Materials and methods. Surgical treatment of 42 patients with unrecognizable and large inguinal hernias was performed. All of them were performed incapacitated plastic with the use of a prone grid. In 12 patients, the Lichtenstein (Lichtenstein group) was performed, 18 patients with a modified technique (TAPP group) and 12 — TEP (TEP group). Modification was a high resection of the hernia sac in patients with inguinal-callous hernia, and the techniques of digestion of the peritoneum with a fixed gut in cases where the intestine is tightly fictoned in a large length to the peritoneum in the area of the hernia sac.
 Results of the research. Application in the performance of transabdominal preperitoneal hernia repair of the technique of high resection of the hernia sac in patients with inguinal-potassium hernia, and methods Surgery, reduce the frequency of hematoma and inflammatory processes in the TAPP surgery area is likely (p < 0.05), and reduce the number of conversions in the TAPP group.
 Conclusions. Diagnostic laparoscopy is a necessary highly informative stage of diagnosis and determination of surgical tactics for complex types of inguinal hernias. Laparoscopic hernia repair of complex forms of inguinal hernias is a method of choice, which provides low trauma, asepticity, good conditions for wound healing. Modified technique of transabdominal preperitoneal hernia repair of complex inguinal hernias, which reduced the trauma of the operation and thus reduce intra and postoperative complications that are manifested by the formation of hematoma and inflammatory processes in the surgery.