A part of your small intestine protruding through a weaker point in your groin is inguinal hernia. Inguinal hernia is commonly noticed among men. Percentage of occurrence of inguinal hernia in women is very small compared to men. Hernia does not cause any serious concern to the affected person. But there are possibilities that hernia may grow in size and cause concern to the affected person. Exertion of strain and physical activities like lifting, bending etc may increase the discomfort and swelling of the hernia.
When you meet your doctor for discussing about your hernia inform him about the medicines that you are now taking for some other ailment. He will advise which medicines have to be stopped for making you fit for the surgery. Your general medical fitness for undergoing the surgery will be ascertained and the extent to which the hernia has increased will also be confirmed by him. For small hernias laparoscopic surgery is preferred as it can be done as a single day process.
Transabdominal preperitoneal (TAPP): In this procedure, the insertion of laparoscope and miniature instruments have to be done very carefully as there is possibility of abdominal injury. TAPP is the most suitable method for bilateral and recurrent hernias and their applicability in the case of unilateral inguinal hernia is debated. In bilateral hernia the benefit of TAPP is that the insertion of laparoscope through one incision can be made use of for doing surgery to both sides.
Aversion to anesthesia is a contraindication for Inguinal Hernia repair. Coagulopathy is another contraindication as bleeding cannot be assessed and controlled postoperatively. Previous surgery in abdominal or pelvic area and large hernia are two relative contraindications. In transabdominal preperitoneal (TAPP) repair, peritoneal cavity is accessed and a synthetic mesh is placed in the regions which will support intestine in its proper place.
Merits of TAPP
1) Both groins are visible in this procedure
2) Better visibility of the Anatomy
3) Mesh can be placed securely
Demerits
1) Violation of abdominal cavity
2) More time needed for surgery
Total Extraperitoneal (TEP): As the name suggests peritoneal cavity is not transgressed in this surgery. Through the incisions in the hernia area, a scope which is a camera light arrangement is inserted into the affected area and surgery is done by the surgeon by viewing the videos images in the monitor placed near him.
Merits of TEP
1) No need to transgress abdominal cavity
2) Better access to operative space
Demerits
1) Peritoneum has to be torn
2) Anatomy not clearly visible
Dr.Kalpana in a panel on PCOS infertility Indian fertility society conference