COMPARATIVE ANALYSIS OF THE TREATMENT OF INGUINALHERNIAS BY TRADITIONAL AND LAPAROSCOPIC METHODS TAPP -IMMEDIATE RESULTS AND COMPLICATIONS

Abstract

Introduction. Operations to eliminate inguinal hernias are one of the most common in surgical practice. In recent years,
laparoscopic techniques, including TAPP, have been widely used in their implementation. For more reliable recurrence
prevention, a technique is proposed that involves suturing the internal inguinal ring during TAPP.
The purpose of the study is to give a comparative description of the results of various methods of inguinal hernia repair
and the nature of postoperative complications depending on the method of intervention and the presence of overweight and
obesity in patients.
Materials and methods. The design of the study is a randomized multicenter clinical trial. The study included 268
patients aged 18 to 84 years (mean age 59.2±10.6 years), including 46 women and 222 men. There were 187 patients with
a normal body mass index, overweight - 72, obese - 9. All patients were divided into 4 groups depending on the method of
intervention: open hernioplasty according to Shouldice (TAPP 29 patients), according to Lichtenstein (118), laparoscopic
TAPP technique (109) and TARR- suturing the internal inguinal ring (12). Based on clinical observation data, the frequency
of early postoperative complications was determined.
Research results: For all identified complications of hernioplasty, an excess of frequency was observed in the presence
of overweight and obesity (χ2=4.331, p=0.038). When using hernioplasty in overweight and obese individuals, the highest
rate of complications was determined. In the TAPP group, the cumulative frequency of exacerbations exceeds 6.4%; there
were no manifestations that differed in the presence or absence of an excess of BMI over normal values. In the TAPP-UVPK
group, there was 1 case of the disease in the presence of increased body weight, which was detected in 4.5% of the total
population and 14.3% of the identified subgroups. complications with the detection of hernioplasty were significant
(χ2=4.660, p=0.031) due to subgroups with increased BMI and obesity (t=0.0001).
Conclusions: 1. Laparoscopic treatment of inguinal hernias using the TAPP technique provides a significant reduction in
the incidence of early postoperative complications, primarily in individuals with an increased body mass index.
2. The use of the TAPP technique with closure of the internal inguinal ring does not increase the risk of early
postoperative complications.