Laparoscopic inguinal hernia repair

Abstract

Because most surgeons were trained to look at groin anatomy from a different direction, the laparoscopic hernia repair at first seems bewildering. However, with experience in visualizing the anatomy from the laparoscopic view, groin anatomy becomes much less confusing. The totally extraperitoneal hernia repair and the transabdominal preperitoneal hernia repair are not mutually exclusive techniques. The surgeon should be welltrained in both techniques because it may become important to convert one technique to the other. The transabdominal preperitoneal technique is easier to learn and the hernia defects are obvious. Once the surgeon is comfortable with that technique, it is natural to progress to the totally extraperitoneal technique. There are proponents of both operative approaches. Whether it be totally extraperitoneal or transabdominal preperitoneal, the structural repair is the same. The mesh that is utilized covers all potential hernia defects to include indirect and direct inguinal hernias as well as femoral hernia defects. The mesh accomplishes this coverage without distorting the abdominal wall anatomy.