Our Summary

This research paper is about a more efficient way to perform laparoscopic repairs for inguinal hernias, which are hernias that occur in the groin area. The traditional open surgery method can lead to chronic pain and a slower return to normal activities. However, laparoscopic surgery (a less invasive technique using a camera and small instruments) has its own drawbacks, such as higher costs, the need for general anesthesia, and increased complexity due to the different anatomy encountered during the surgery.

The researchers have proposed a new standardized method for laparoscopic repairs called the transabdominal laparoscopic repair (TAPP) technique. This technique uses an “inverted Y” concept and identifies five triangles and three zones of dissection in the anatomy to ensure a safe and effective surgery. This system has been taught to many surgeons over the past five years, and has been found to be easy to learn and reproduce, leading to its widespread adoption.

FAQs

  1. What is the traditional method of hernia repair and what are some of its drawbacks?
  2. What is the transabdominal laparoscopic repair (TAPP) technique and how does it improve upon traditional methods?
  3. What are some of the challenges associated with laparoscopic hernia repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic hernia repair using the TAPP technique is to follow post-operative care instructions closely. This may include avoiding heavy lifting, staying hydrated, taking prescribed medications, and keeping the incision site clean and dry. Following these instructions can help promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair using the TAPP technique include those with inguinal hernias, especially recurrent hernias or bilateral hernias. This technique is also recommended for patients who are looking for a faster recovery time and lower risk of chronic pain compared to traditional open surgery. Additionally, patients who are at a higher risk for complications with open surgery, such as those with obesity or previous abdominal surgeries, may also benefit from laparoscopic hernia repair using the TAPP technique. Ultimately, the decision to recommend laparoscopic hernia repair will depend on the individual patient’s specific circumstances and the recommendation of their healthcare provider.

Timeline

Before laparoscopic hernia repair:

  • Patient experiences symptoms of a hernia such as pain, discomfort, and a bulge in the groin area
  • Patient undergoes a physical examination and possibly imaging tests to confirm the presence of a hernia
  • Patient discusses treatment options with their healthcare provider, including the possibility of laparoscopic hernia repair
  • Patient may undergo pre-operative testing and preparation for the surgery

After laparoscopic hernia repair:

  • Patient undergoes laparoscopic hernia repair using the TAPP technique
  • Surgery is performed under general anesthesia, and small incisions are made in the abdomen for the camera and instruments
  • Surgeon identifies five triangles and three zones of dissection in the anatomy to ensure a safe and effective surgery
  • Patient may experience less pain, faster recovery, and a quicker return to normal activities compared to traditional open surgery
  • Patient is monitored post-operatively for any complications and is given instructions for post-operative care and follow-up appointments.

What to Ask Your Doctor

  1. What are the benefits of laparoscopic hernia repair compared to traditional open surgery?
  2. What are the potential risks or complications associated with laparoscopic hernia repair?
  3. How long is the recovery time for laparoscopic hernia repair compared to open surgery?
  4. Will I need general anesthesia for the laparoscopic procedure?
  5. How experienced are you in performing laparoscopic hernia repairs using the TAPP technique?
  6. What is the success rate of the TAPP technique in treating inguinal hernias?
  7. Are there any specific post-operative instructions or restrictions I should follow after the surgery?
  8. How long will I need to stay in the hospital after the laparoscopic hernia repair?
  9. What are the costs associated with laparoscopic hernia repair and will my insurance cover it?
  10. Are there any alternative treatment options for my inguinal hernia that I should consider?

Reference

Authors: Furtado M, Claus CMP, Cavazzola LT, Malcher F, Bakonyi-Neto A, Saad-Hossne R. Journal: Arq Bras Cir Dig. 2019 Feb 7;32(1):e1426. doi: 10.1590/0102-672020180001e1426. PMID: 30758474