The key points for improving the safety and effectiveness of laparoscopic inguinal hernia repair
LI Jian-wen
YUE Fei
XUE Pei
Abstract：Abstact The safety of laparoscopic inguinal hernia repair(LIHR)is central to ensuring its efficacy.Its efficacy is primarily defined by the patient's experience of optimal therapeutic outcomes.The indications for LIHR are essentially the same as those for open surgical approaches.The Total Extraperitoneal(TEP)or Transabdominal Preperitoneal(TAPP)technique is recommended for primary inguinal hernias.Meanwhile,for complex inguinal hernias,TAPP or Lichtenstein repair is preferred.LIHR can be performed under various anesthetic modalities,with general anesthesia being the preferred choice to maintain a stable surgical environment.Surgeons should master concepts of parietal plane,visceral plane,and plane transition during the procedure.The reduction of direct hernias involves the separation of the transversalis fascia from the preperitoneal fascia.In contrast,the reduction of indirect hernias requires the separation of the peritoneum from the preperitoneal fascia,with the spermatic cord passing through this space.The two main strategies for minimizing postoperative seroma formation are dead space closure and wound minimization.Lightweighted,non-absorbable,or partially absorbable macroporous mesh is the preferred material.The long-term mechanism of absorbable,degradable meshes still requires further clinical evidence.Mechanical or penetrating fixation techniques should be avoided if possible.Drain placement is not indicated in the absence of specific clinical indications.Postoperative local compression in the inguinal area or wearing hernia support pants may help alleviate pain and reduce the incidence of seroma formation.
Keywords：inguinal hernialaparoscopysafetyeffectiveness
Publication Date：2025-01-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 84-88 )