Preperitoneal Prosthetic Repair (Open Tep) for Inguinal Hernias

Abstract

Background: Inguinal hernia is repaired by placing a polypropylene mesh in the preperitoneal space. The entire procedure is perfomed through a small 3-4 cm incision made in the midline above the pubic symphysis. Pre peritoneal space created by simple digital dissection and retraction. Clear visualisation of the operative site is maintained throughout the procedure with proper dissection. Materials and Methods: One hundred Inguinal Hernia patients including direct, indirect and recurrent inguinal hernias operated under spinal/ epidural anaesthesia by placing polypropylene mesh in the preperitoneal space which is created by digital dissection by giving small incision (3-4 cm) in the lower midline above the pubic symphysis. Results: We found open TEP is beneficial in terms of less operative time. Open TEP also has the advantage of direct visualisation of anatomy, decreasing the learning curve for laparoscopic TEP, avoiding damage to the nerves and less incidence of seroma and hematoma formation and lesser incidence of recurrence. Conclusion: It is an efficient inguinal hernia repair method having all the advantages of Stoppas GPRVS and Laparoscopic TEP with good cosmosis, less cost and better patient compliance.