CAUSES AND PREVENTION OF RELAPSE IN TRANSABDOMINAL PRE-PERITONEAL ALLOPLASTY OF INGUINAL HERNIAS

The aim of this work was to improve the results of surgical treatment of inguinal hernias using TAPP.

Materials and methods. The analysis of surgical treatment of inguinal hernias using TAPP in 86 patients male aged 25 to 75 years. In the first group (43 patients) were performed classical TAPP, the second (43 patients) improved TAPP. Advanced TAPP differed from the classical fact that the mesh “ultrapro” implant 12 ´ 15 cm was placed 3–4 cm below the Cooper ligament and iliac vessels. At the level of the iliac vessels it was fixed with acrylic adhesive.

Results and discussion. Immediate results were comparable: seroma of the abdominal wall was detected in 2 (4.6%) patients of the first group and 3 (6.9%) patients of the second group, scrotal hematoma — 3 (6.9%) in the first group and 2 (4.6%) patients of the second group. Long-term results from1 to 5 years were studied in 30 patients of the first group and 31 — second one, the relapses were detected only in 3 patients (10%) of the first group. This result has been achieved thanks to a more robust strengthening of the defect in the inguinal area preperitoneal posted by mesh implant and mobilization preperitoneal space of 3–4 cm below the ligament of Cooper.

Conclusions. The use of advanced transabdominal preperitoneal alloplastic by a wider overlap area at the level of the Cooper’s ligament and iliac vessels mesh implant and the fixation of acrylic adhesive ensures reliability alohernioplastics and prevention of recurrence of inguinal hernias.