Abstract:
Groin hernia repair is the most common procedure performed by general surgeons. The open mesh technique generally represents the main technique for an inguinal repair, but a different approach is often required. Laparoscopy was found to be the answer to minimizing the impact of the preperitoneal open techniques described by Nyhus and Stoppa. The introduction of the totally extraperitoneal hernia repair (TEP) and transabdominal preperitoneal repair (TAPP) in the early 1990s started a new chapter in groin hernia surgery. The minimally invasive techniques vs. open mesh, and then one against the other, soon became a hot topic among abdominal wall surgeons. With time, the number of procedures and indications increased and are still increasing. This review aims to provide an overview of the two main laparoscopic techniques for groin hernia repair, answering the following questions: Who should perform them? What is the learning curve required to minimize complications and optimize operative time? When is a minimally invasive approach indicated, and which one (both in elective and in emergency setting)? How are they performed? The standard techniques have been described in detail, and personal observations from an abdominal wall surgery referral center were added. The main reviews from the early 2000s up to date, which compared the techniques, were analyzed, and the results reported, confirming the comparable safety and efficacy of both these techniques.
摘要:
腹股沟疝修补术是普通外科医生最常见的手术。开放网格技术通常代表腹股沟修复的主要技术,但是通常需要不同的方法。发现腹腔镜检查是最大程度地减少Nyhus和Stoppa描述的腹膜前开放技术影响的答案。1990年代初期,完全腹膜外疝修补术(TEP)和经腹腹膜前疝修补术(TAPP)的引入开启了腹股沟疝手术的新篇章。微创技术与开放网格,然后一个对另一个,很快成为腹壁外科医生的热门话题。随着时间的推移,手术和适应症的数量增加了,而且还在增加。这篇综述旨在概述两种主要的腹腔镜腹股沟疝修补术技术,回答以下问题:谁应该执行它们?最小化并发症和优化手术时间所需的学习曲线是什么?哪一个(在选修和紧急设置中)?他们是如何执行的?标准技术已经详细描述,并增加了来自腹壁外科转诊中心的个人观察.从21世纪初至今的主要评论,比较了这些技术,被分析,和报告的结果,证实了这两种技术的相当的安全性和有效性。