JUSTIFICATION
Endoscopic inguinal hernioplasty is one of the most common operations in general surgical hospitals. Laparoscopic hernioplasty using the TAPP method is more common among domestic surgeons because is the usual surgical techniques for a doctor who knows endoscopic surgical techniques. However, the TEP technique has significant advantages over the TAPP technique, but the attitude of surgeons to this technique remains restrained due to the more complex intervention technique and insufficient understanding of the multifascial anatomical structure of the anterior abdominal wall.
PURPOSE OF THE STUDY
Clarification of the features of the multifascial structure of the anterior abdominal wall and substantiation from the topographic-anatomical and clinical positions of endovideohernioplasty using the TEP method.
MATERIAL AND METHODS
The features of the anatomical structure of 11 corpses of those who died from diseases not associated with the pathology of the abdominal organs were studied. The study was carried out using the method of anthropometry, morphometry, preparation of the anterior abdominal wall. The clinical study was based on data on 731 patients with inguinal hernias.
RESULTS
In the course of the study, the holy plane has determined, in which it is necessary to dissect the tissues when performing hernioplasty according to the TEP method. It was found that the duration of the operation using the modified TEP method was 43±15 minutes (p≤0.05). The early postoperative period in all cases was uneventful, pain syndrome according to the visual analogue scale was 1—2 points. The average length of hospital stay after surgery was 2.6±0.3 days (p≤0.05). Complications were diagnosed in 7 (0.9%) patients, most of whom were grade II according to the Clavien-Dindo classification. Recurrences were diagnosed in 2 (0.3%) cases.
CONCLUSION
The active introduction of minimally invasive methods of inguinal hernioplasty has determined the necessity of a clear understanding of the multifascial structure of the anterior abdominal wall and the clinical and anatomical justification of surgical approaches. The use of a modified TEP method reduces the risk of both intra- and postoperative complications, allowing for good treatment results.
