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An inguinal hernia is a weakening of a section of the abdominal wall that is large enough to allow soft tissues or internal organs to penetrate, especially part of the intestine. An inguinal hernia usually presents as a protrusion, and in some patients it can cause pain and discomfort, limiting daily activities and working capacity. If there is an infringement of the intestine or its obstruction, then the condition can become life-threatening. Hernia repair is usually performed using a synthetic mesh, either in an open way, or increasingly, less invasive laparoscopic surgery is used. The most common laparoscopic treatments for inguinal hernia are transabdominal preperitoneal (TAPP) hernioplasty and total extraperitoneal (PVB) hernia repair. In transabdominal preperitoneal hernia repair (TAPB), a surgeon enters the abdominal cavity and places a mesh through the peritoneal incision over a possible hernia. Extraperitoneal hernioplasty (PVB) differs in that the entrance to the abdominal cavity is not performed, and the mesh is used to close the hernia outside of the peritoneum (a thin membrane covering the organs in the abdominal cavity). This approach is considered more complex than transabdominal hernioplasty, but may have fewer complications. According to the results of nine studies, there was a slight increase in the number of hernias developing next to surgery and trauma to internal organs during transabdominal preperitoneal hernia repair, and an increase in the frequency of switching to another method of surgical treatment of hernia during extraperitoneal hernia repair was found.

TREATMENT

Treating groin hernias (inguinal hernias) is the most commonly performed procedure in general surgery. The hernia is repaired (with suturing or placing a synthetic mesh over the hernia in one of the layers of the abdominal wall) using either open surgery or laparoscopy with minimal access. The most common laparoscopic methods for repairing an inguinal hernia are laparoscopic transabdominal preperitoneal hernia repair (TAPB) and total extraperitoneal (TEP) hernioplasty. In TAPB, the surgeon reaches the abdomen and places the mesh through the abdominal incision over possible hernia sites. TEP is different because the abdominal cavity does not open, and the mesh is used to isolate the hernia outside the thin membrane that covers the abdominal organs. In laparoscopic treatment, nerve or major vessel injury, bowel obstruction, and bladder injury have been reported. Recurrence (reappearance) of a hernia is one of the main disadvantages.
The review authors identified 41 eligible controlled trials in which a total of 7161 participants were randomly selected for laparoscopic and open surgery and had less persistent pain and numbness than open surgery.
 

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