Laparoscopic Inguinal Hernia repair involves laparoscopic reduction of the hernia sac and placement of a mesh. This can be done by two techniques:
Trans Abdominal Preperitoneal(TAPP) repair- This a transperitoneal approach and requires a preperitoneal flap creation.
Total ExtraPeritoneal(TEP) repair- This involves creation of a preperitoneal space using a balloon or similar device. Peritoneum is not breached.
Obstructed or irreducible hernias
Unfit for General Anaesthesia
Multiple abdominal or preperitoneal space surgeries resulting in adhesions
Lesser postoperative pain
Short hospital stay
Lower rerecurrence rate in case of recurrent hernias
Single incision for bilateral hernias
Earlier return to routine activities
Types of mesh used: Polypropylene light weight meshes are most commonly used. Polyester or PTFE meshes can also be used. These are fixed with tackers to the abdominal wall.
Infection: may need mesh removal
Bowel or bladder injury
Recurrence: is between 1-3%
Chronic groin pain: either due to nerve injury by tackers , reaction to mesh
Adhesion of bowel to mesh and fistula formation
Numbness in thigh area