Morphological justification of laparoscopic transabdominal preperitoneal (TAPP) operation for the inguinal hernia recurrence
| Main Authors: | Feleshtynskyi, Y. P., Shtaier, A. A. |
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| Format: | Article eJournal |
| Terbitan: |
, 2020
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| Online Access: |
https://zenodo.org/record/4037143 |
Daftar Isi:
- Feleshtynskyi Y. P., Shtaier A. A. Morphological justification of laparoscopic transabdominal preperitoneal (TAPP) operation for the inguinal hernia recurrence. Journal of Education, Health and Sport. 2020;10(9):455-463. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.054 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.054 https://zenodo.org/record/4037143 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.08.2020. Revised: 01.09.2020. Accepted: 18.09.2020. Morphological justification of laparoscopic transabdominal preperitoneal (TAPP) operation for the inguinal hernia recurrence Y. P. Feleshtynskyi, A. A. Shtaier Kyiv municipal hospital clinic #5, Kyiv, Ukraine P. L. Shupyk National Medical Academy of Postgraduate Education Department Surgery and Proctology Kyiv, 04112 Ukraine, 9 Dorohozhytska Str. Y. P. Feleshtynskyi, Doctor of Science (Medicine), Department Surgery and Proctology, P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv City Clinical Hospital No 5, Ukraine, Kiev city, Rest street 11, e-mail: feleshtynsky@yahoo.com tel. +380674434090 A. A. Shtaier, graduate student, Department Surgery and Proctolog, P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv City Clinical Hospital No 1 Ukraine, Kiev city, Kharkov highway 121, e-mail: kolochava@ukr.net tel. +380672876136 Abstract Introduction. The frequency of the inguinal hernia of the repeated recurrences is up from 9,3 to 12%. In surgical treatment re-fixation of the mesh to the atrophied tissues of the inguinal canal is unreliable. The posterior access can be much more reliable for the patients, in which the mesh will be fixed to the unchanged muscular-aponeurotic tissues of the inguinal area. Aim. To increase the efficiency of recurrent inguinal hernias surgical treatment by justification of using the TAPP surgical technology. Materials and methods. An analysis was made in the clinic Kiev City Clinical Hospital No. 5. about surgical treatment of recurrent inguinal hernias in 105 patients. Surgical operations were also divided. The patients were divided into 2 groups, the first group (52), where the Liechtenstein's operation was repeated, and the second group of the patients (53) were confirmed by TAPP (patent No. 1299.1 from 26.11.18). A biopsy of the inguinal muscle aponeurotic tissues was made during surgery in both groups of the patients. Also morphological examination was made. For a final comparison of the morphological examination of inguinal tissues, a biopsy was performed in 20 patients who had an appendectomy. Results and discussions. In I group to the remote period in 8 (16%) patients there were chronic inguinal pain and recurrence of hernia was observed in 4 (8%) patients. In II group long-term results were as follows, chronic inguinal pain was diagnosed in 2 (4%) patients, recurrence was observed in 1 (2%) patient. After making a morphological comparison of the three groups, it was found that in group I were signs of severe chronic inflammation with the formation of granulation of the tissue, scar tissue, destruction of elastic fibers, both in the tissue of the anterior abdominal wall and in the wall of the vascular component. The morphological picture of the II and III groups are similar, with weakly expressed chronic inflammatory infiltration, with savings of the elastic fibers and less degenerative changes. Conclusion. The morphological reasoning of the use of improved TAPP was the absence of atrophic changes in the muscular-aponeurotic tissues of the inguinal region, while in Liechtenstein's second operation there was atrophy, scarring of inguinal tissues, so fixation of the mesh to such tissues can leads to recurrence. Key words: recurrent inguinal hernia; ТАРР; morphological justification