THE SURGICAL TREATMENT OF INGUINAL HERNIA USING THE LAPAROSCOPIC TOTALLY EXTRA-PERITONEAL (TEP) TECHNIQUE

The surgical repair of inguinal hernia represents one of the most frequent procedures used in general surgery. The new surgical techniques are simpler, with a lower morbidity and recurrence of less than 2%. The laparoscopic totally extra-peritoneal (TEP) technique is contraindicated in complicated hernias (occlusion, incarceration) and in voluminous inguino-scrotal hernias. Purpose. the evaluation of the TEP technique, of the risk factors and of the postoperative results on the group of patients who have undergone surgery in the Surgical Clinic 2 Cluj Napoca. Material and method. The study is prospective, on a group of 40 patients operated with the TEP technique in the Surgical Clinic 2 during the period May 2013 – July 2014. The following have been assessed: the demographic data, the risk factors, the immediate complications, the recurrence of the hernias. Results. The average duration of hospitalization was 6.79 days. The intraoperative incidents were: 7 minimal peritoneal lesions with pneumoperitoneum and a hemorrhagic lesion of the epigastric vessels repaired endoscopically by the clipping of the lesion. There were 2 recurrences, 24 hours and 1 year after surgery, solved by the Lichtenstein technique. After 30 interventions, the average duration of the surgery was of 64 minutes, being longer in the case of bilateral hernias and being influenced by the team’s learning curve. Conclusions. The TEP technique is a safe option followed by a low rate of complications, a low recurrence rate and low intensity postoperative pain