Extraperitoneal Laparoscopic Approach in Inguinal Hernia-The Ideal Solution?

Abstract

<h4>Background</h4>After more than 20 years since laparoscopy was proposed as a solution for one of the most common surgical pathologies, inguinal hernia, the choice of an intra- or extraperitoneal approach has remained a highly debated topic.<h4>Purpose and objectives</h4>This study aimed at analyzing the feasibility of the extraperitoneal approach, by routine for this team/ and answering the question of whether this type of approach can be considered a safe one. Although indications for an intra- or extraperitoneal approach largely overlap, it may also be a matter of surgeon preference in choosing one technique.<h4>Methods</h4>The study was retrospective, conducted on a group of 493 patients operated on for inguinal hernia in the clinic, by a single operating team, between January 2012 and March 2022.<h4>Results</h4>It was proven that out of the 493 surgeries for inguinal hernia, 95.1% (<i>n</i> = 469) were operated upon by laparoscopic TEP (total extra peritoneal patch plasty approach); 1.62% (<i>n</i> = 8) by laparoscopic TAPP (transabdominal intraperitoneal); and 3.24% (<i>n</i> = 16) by the open, anterior approach (Lichtenstein). There were no intraoperative complications recorded in any of the procedures, while postoperative complications were found in 10.23% of cases (<i>n</i> = 48) in the extraperitoneal approach, and recurrences after the TEP approach were recorded in 0.40% of cases (<i>n</i> = 2).<h4>Conclusions</h4>For correctly selected cases, TEP hernia surgery can be considered a safe and reliable approach.