|TREATMENT OF INGUINAL HERNIA
The inguinal hernia consists out of a bulging of an intra-abdominal organ through the lower abdominal wall (in the pubic region). A bulging is seen in the groin. Either deductible under light pressure or in decubitus or non-deductible and painful (stranglutated hernia)
One can find three types of inguinal hernias:
- Direct: directly through the abdominal muscular wall.
- Indirect: in men following the spermatic cord to the scrotum, in women following the round ligament to the labia.
- Crural: following the femoral vessels.
A direct hernia can co-exist with a indirect hernia: called a combined hernia
The intervention consists out of placing a non-resorbable prosthetic mesh (see picture) over the three orifices of the hernia. In this mesh scar tissue will be formed to make a strong addition to the muscular wall.
(Click on picture to enlarge)
The laparoscopy allows two ways of approach:
By a trans-peritoneal route – TAPP with opening en closing the peritoneum
By an extra-peritoneal route - TEPP (just boarding the peritoneum) without entering abdominal cavity, the procedure is performed between the muscular wall and peritoneum.
Either technique has excellent results: 1% reoccurs over a period of 10 years
The intervention necessitates 3 trocar holes. Discharge of the patient, can be form 24 to 48 hours after surgery
(Click on pictures to enlarge)