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Inguinal hernia is one of the most common causes of admission to surgery with over half a million repair procedures taking place each year worldwide. With the emergence of the laparoscopic approach, inguinal hernia repair is now immediate, bloodless and as painless as possible. However, in many cases, inguinal hernias can recur.

• What is an inguinal hernia and how is it treated?

Inguinal hernias are the most common form of hernia and involve the prolapse of a section of the intestine into the inguinal canal. It is a condition that poses risks to the patient’s health and if left untreated can become constricted and cause life-threatening intestinal perforation and peritonitis. This is why an inguinal hernia must be repaired immediately. Inguinal hernia repair can only be done surgically, either by open surgery or laparoscopically. Laparoscopic inguinal hernia repair began in the 1990s and was quickly adopted by surgeons around the world. There are different laparoscopic approaches to inguinal hernia repair, such as transabdominal preperitoneal repair (TAPP) and totally extraperitoneal (TEP).

• What is laparoscopic preperitoneal repair and what are its advantages?

In the TAPP method, the surgeon enters the peritoneal cavity and places a mesh through a peritoneal incision over potential hernia sites. Inguinal hernia repair with TAPP has very good results, especially in the case of bilateral hernias, as the two incisions in the groin that are required in open surgery are avoided.

Due to the minimal tissue trauma, recovery is rapid and return to work is quick. TAPP repair is a good alternative in recurrent cases, where the previous repair of the original inguinal hernia was done through the anterior approach. It also gives the advantage of identifying any concomitant femoral hernia, contralateral hernia or even obstructive hernia.

As for the operation itself, we normally perform the TAPP procedure using a non-preformed prolene mesh (15×15 cm). This mesh is divided into two parts. The first is shaped to be placed under the spermatic cord and vessels. The second is used to cover these structures and the opening of the lower mesh as a top layer. Both pieces are fixed using a special glue, instead of the absorbable staples of the past. In this way, the possibility of recurrence is minimized, as well as postoperative pain, hospital stay (one-day procedure) and recovery time.

• How soon can the patient return to daily activities and work?

The special glue used to fix the double mesh to the hernia site reaches its maximum strength approximately three weeks after the operation. Therefore, if the patient does light and sedentary work, he can return to it within 2-4 days. For heavy work, he should wait until the end of the three weeks required for maximum strengthening of the mesh adhesion.

The Athens Medical Group supports the most modern therapeutic approaches for the treatment of inguinal hernia, including laparoscopic access, completely avoiding large incisions in the anterior abdominal wall.