CHOICE OF INGUINAL HERNIA REPAIR PROCEDURE

Abstract

Introduction. Modern surgical approaches to inguinal hernia repair are laparoscopic (TAPP and TEP) and open (Lichtenstein procedure), which are based on prolene mesh prosthetics. Despite the widespread use of these methods of hernia repair in surgical practice, the frequency of typical postoperative complications: hematoma of the scrotum and inguinal region, false recurrence, paresthesias, neuralgia, etc.
 Aim. To compare TAPP, TEP, and Lichtenstein based on analysis of long-term treatment outcomes.
 Materials and methods. We performed surgical treatment of inguinal hernia in 211 patients. All of them underwent tension-free hernia repair using a prolene prosthesis. Lichtenstein procedure was performed in 65 patients (Lichtenstein group), TAPP (TAPP group) in 81 patients and TEP (TEP group) in 65 patients. In 30 patients of different groups, the blood flow in the vessels of the testis was studied after the procedures performed within 45–60 days.
 Results. Probably (p<0.001) faulty recurrence was observed more often in the Lichtenstein group. Seromas that persisted for more than 30 days (p<0.01) and seromas that required surgical intervention — puncture (p<0.05) were more likely to be noted in the TEP group. Indicators such as hernia recurrence (up to one year) and the intensity and frequency of chronic postoperative neuralgia in the Lichtenstein, TAPP and TEP groups differed improbably. The systolic velocity of blood flow in the vessels of the testis in patients of the Lichtenstein group before the operation was (19.70±3.53). In the postoperative period, an incredible decrease in blood flow was observed (19.28±3.41). In patients of the TAPP group, the preoperative systolic velocity was (19.83±3.27) and improbably decreased to (19.47±3.44) within 45–60 days. A similar improbable decrease was observed in the TEP group — (19.80±3.56) and (19.63±3.51)
 Conclusions. The Lichtenstein procedure and endoscopic methods of inguinal hernia correction (TAPP and TEP) are safe procedures in terms of long-term complications and do not likely affect the systolic blood flow velocity in the testicular arteries.