TRANSABDOMINAL PREPERITONEAL PLASTIC WITH RECURRENT INGUINAL HERNIA

Background. The relapse rate after the plastic of the inguinal hernia of Liechtenstein remains rather high, 5-15%. For the treatment of recurrent inguinal hernia, a repeated Liechtenstein operation is often used, after which the number of recurrent relapses is before 20%. The implementation of the laparoscopic transabdominal preperitoneal alloplasty (TAPP) would be more appropriate as the fixation of the mesh implant would be performed from the abdominal cavity to the scarring of the unchanged muscles of the inguinal site. Purpose of the study: to improve the results of surgical treatment of recurrent inguinal hernias using TARR. Materials and methods: 85 patients with recurrent inguinal hernias, which arose after the operation of Liechtenstein. The first group (main), 43 patients who were operated according to the advanced TAPP technique, the second group (comparison), 42 patients operated by the Liechtenstein method. Improved TAPP was performed under general anesthesia, in which wider mobilization on the upper edge of the parietal peritoneum was used for 3-4 cm, placed a wider rate implant 3-4 cm (15X15 cm). In the comparison group, patients were operated using the classical technique of Liechtenstein. Patients were observed in the early postoperative period, 6 months, 1 year. Results and discussion. When TAPP is performed in recurrent inguinal hernias, 5 (11.6%) serum on the side of surgical intervention, 0% suppuration of wound. In 2 (4.5%) patients, chronic pain was observed for 6 months, in 1 patient (2.3%), after 6 months there was a recurrence. In the second group, 8 patients (19.04%) had subcutaneous hematomas, serum in 7 (16.6%), and 2 (4.7%) suppurative postoperative wounds. Chronic pain 9 (21.4%) patients, in 3 (7.1%) was a recurrence. Conclusion. The use of advanced TAPP improves the results of treatment for recurrent inguinal hernias, the reduction of the overall postoperative frequency is complicated, the absence of suppuration of the wound, the smaller the number of patients with chronic pain, the number of relapses with TAPP 2,3%, in the plasticity