"GOLD STANDARD" OF ENDOSCOPIC INGUINAL HERNIOPLASTY

Endoscopic operations performed by a herniological patient are becoming increasingly common in specialized hospitals. At the same time, despite the large flow of patients in this category, the optimal option for minimally invasive surgery is not yet specified. Thus, the problem remains unresolved: which of the endoscopic plasty methods is preferable - TAPP (transabdominal preperitoneal plasty) or TEP (total extraperitoneal plasty)? The aim of the study was to evaluate the results of surgical treatment of patients with inguinal hernias with a minimally invasive method according to the TAPP and TEP methods, followed by justification of the appropriateness of using one or another endoscopic technique. The results of treatment of 1015 patients with inguinal hernias operated on from 2014 to 2019 were studied. (331 patients were operated laparoscopically - TAPP and 684 patients - according to the TEP technique). The learning curve with TAPP averaged 30 interventions performed, with TEP 45-50. The duration of surgery using the TAPP technique was longer compared to TEP. In all cases, the early postoperative period was uneventful, pain according to the VAS scale was greater in the group of patients operated on laparoscopically. Later postoperative complications developed with the same frequency - in the TAPP group in 0.9% of patients, after TEP in 1.2% of patients. Relapse of the disease was diagnosed in 3 cases (0.9%) after laparoscopic hernioplasty, and after surgery according to the TEP technique, in 3 cases (0.4%). At the same time, TEP hernioplasty favorably differed from laparoscopic intervention by the absence of the need to use endogeniostepler, less pain and a shorter postoperative bed-day.

endoscopic surgery, laparoscopic hernioplasty, total extraperitoneal hernioplasty, TAPP and TEP