ENHANCED TRANSABDOMINAL PREPERITONEAL REPAIR (TAPP) IN PATIENTS WITH INCARCERATED INGUINAL HERNIAS
DOI:
https://doi.org/10.11603/2414-4533.2025.1.15179Keywords:
inguinal hernia, hernia incarcerated, laparoscopy, transabdominal preperitoneal repair (TAPP), surgical mesh, postoperative complications, seroma, wound infectionAbstract
The aim of the work: the study aimed to improve the efficacy of surgical treatment for incarcerated inguinal hernias using an enhanced TAPP technique with mesh fixation and peritoneal closure via an antiseptic adhesive composition.
Materials and Methods. From 2019 to 2024, 85 patients (aged 20–75, mean 42±1.3) underwent surgery at the Surgery and Proctology Clinic of the Shupyk National Healthcare University, Ukraine. Patients were divided into two groups based on the TAPP technique. Group I (n=43) underwent enhanced TAPP with preperitoneal fixation of a polypropylene mesh and peritoneal closure using polyurethane glue and decamethoxin. Group II (n=42) underwent traditional TAPP with tack mesh fixation and suturing for peritoneal closure. Patients with phlegmon of the hernial sac or bowel loop necrosis were excluded.
Results. In the first group of patients who underwent advanced TAPP, seroma was present in 1 (2.3%) patient, mesh infection was not observed, chronic postoperative pain was present in 1 (2.3%) patient, and inguinal hernia recurrence was also present in 1 (2.3%). In the second group of patients who underwent TAPP using the traditional method, seroma was present in 12 (28.5%), mesh infection was present in 7 (4.7%), chronic postoperative pain was present in 6 (14.2%), and recurrence was present in 5 (11.9%) patients. The use of adhesive peritonization minimized the formation of “dead space” above the mesh, which contributed to a decrease in the incidence of complications.
Conclusions. Advanced TAPP with adhesive peritonization effectively reduces the incidence of postoperative complications and hernia recurrence compared to the traditional TAPP technique. This technique provides a safer option for the treatment of incarcerated inguinal hernias.
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