Slovenská chirurgia 3/2014

Perioperative complications of transabdominal preperitoneal hernioplasty (TAPP) in our database

Operation of inguinal hernia is one of the elementary surgeries. Development of miniinvasive surgery towards the end of the 20th century offered a laparoscopic solution of inguinal hernia. Two types of laparoscopic hernioplasty are most widely used: TAPP (Trans-Abdominal Pre-Peritoneal) and TEP (Totally Extra-Peritoneal). Both are based on tension-free principles of hernioplasty with preperitoneal mesh insertion. In our study we evaluated our own experiences with perioperative complications on the basis of retrospective analysis of the database of patients operated in the course of 15 years and compared them with the data in the available literature. We focused on ductus deferens injury and injury of epigastric vessels. During this period 1 762 TAPP hernioplasties were performed including one-sided, two-sided, or relapse of hernias after prior classical or laparoscopic surgery. In 6 patients ductus deferens was injured, which represents 0,3 %, in 2 patients bleeding from place of port insertion required revision, which is 0,1 % and injury of epigastric artery occurred in 7 patients perioperativelly at preparation, which represents 0,4 % out of the total number of hernioplasties. No injury of main vessels or other organs was recorded in our database of patients. Despite the above mentioned complications it may be concluded, in line with the data in the available literature, that laparoscopic hernioplasty is an ideal method to solve inguinal hernia by operation with all advantages of miniinvasive approach. In line with the IEHS (International Endohernia Society) recommedations we propose the ways how these perioperative complications can be prevented.

Keywords: laparoscopy, TAPP, perioperative complications.