This technique of hernia repair does not involve entering the abdominal cavity to repair the hernia.
The potential space between the peritoneum and the muscles of the abdominal wall is employed.
Special balloon devices have been developed to facilitate this operation:
The first balloon dissects this potential space.
The second permits surgery within this space.
The hernia and its contents are returned to the abdominal cavity and large pieces of mesh inserted to cover the "defect".
Traditionally this mesh is secured to the patient's muscles with titanium tacks or staples.
The gas is then let out of this space to allow the peritoneum to again come into contact with the abdominal muscles.
Newer developments have seen the release of curved meshes which conform to the shape of the abdominal wall.
These meshes do not need to be fixed in order for them to securely remain in place.
There are theoretical advantages to not using a fixation device to hold in the mesh.
The recurrence rate following this method of hernia repair is at least as low as any other method in experienced hands.
One of the potential complications of neuralgia (nerve pain) may well be reduced in the non secured mesh repair as it avoids the potential of "spiking" a nerve fibre with the fixation device.
The advantages of a TEP laparoscopic hernia repair include:.
Approximately 30% of patients will develop a hernia on the other side.
If an early hernia is noted on the other side at the time of surgery it may be repaired easily without recourse to further operations or scars.
Normal activity is quickly achieved as this repair can be performed as a "day case" even in bilateral hernias.