PDF (5 MB) - Jurnalul de Chirurgie

SURGICAL TECHNIQUE & MULTIMEDIA 193Jurnalul de Chirurgie (Iaşi), 2013, Vol. 9, Nr. 2LAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL(TAPP) PROCEDURE FOR GROIN HERNIA.HOW TO DO IT FOR BETTER OUTCOMESR. Moldovanu 1) Department of surgery, University of Medicine and Pharmacy “Gr.T. Popa” Iaşi, Romania2) Department of surgery and oncology, Les Bonnettes Hospital, Arras, FranceLAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL PROCEDURE (TAPP) FORGROIN HERNIA. HOW TO DO IT FOR BETTER OUTCOMES (Abstract): The laparoscopicapproach for the groin hernia repair has several advantages: decreased immediate and latepostoperative pain, less numbness in inguinal aria, less mesh infection and a rapid recovery.However the good outcomes are not granted, and there are some key points to be followed forbetter postoperative results. The aim of this video is to highlight these TAPP (TransAbdominalPre-Peritoneal) related key points, from the operative indication, pre operative preparation andsurgical procedure, until the post operative follow up.KEY WORDS: LAPAROSCOPY; GROIN HERNIA; TRANSABDOMINAL PRE-PERITONEAL PROCEDURE (TAPP)SHORT TITLE: TAPP – How to do itHOW TO CITE: Moldovanu R. Laparoscopic transabdominal pre-peritoneal procedure (TAPP) for groin hernia. How todo it for better outcomes. Jurnalul de chirurgie (Iaşi). 2013; 9(2): 193-196. DOI: 10.7438/1584-9341-9-2-13.VideoBACKGROUNDThe laparoscopic approach for thegroin hernia repair has several advantages:decreased immediate and late postoperativepain, less numbness in inguinal aria, lessmesh infection and a rapid recovery [1].However the good outcomes are not granted,and there are some key points to be followedfor better postoperative results.The aim of this video is to highlightthese TAPP (TransAbdominal Pre-Peritoneal) related key points, from theoperative indication, pre operativepreparation and surgical procedure, until thepost operative follow up.TAPP INDICATIONS:TAPP can be performed in any type ofhernia, even in complicated (strangulated)Received date: 28.02.2013Accepted date: 12.03.2013Correspondance to: Radu Moldovanu, MD, PhDDepartament of Surgery and Oncology, Les Bonnettes Hospital, Arras, France2 rue Dr. Forgeois, 62012, Arras, Cedex, FrancePhone: 0033(0) 3 21 60 22 70Fax: 0033(0) 3 21 60 22 58E-mail: rmoldovanu@gmail.comhernia [2,3]. Relative contraindications arethe large inguino-scrotal hernias and historyof radical prostatectomy [2,3]. Differentgeneral comorbidites (e.g. heart failure,chronic respiratory disease) cancontraindicate the general anesthesia and, asconsequence, the TAPP [2,3].PREOPERATIVE PREPARATIONThere is no particular preparation;however it has to be highlighted theimportance of comorbidites evaluation andadequate skin preparation. In this way it isimportant to note the preoperative antisepticshower, the hair removing using a barberclipper, use of alcoholic based solution forskin preparation and the bladder emptyingjust before the procedure (facilitate thedissection and avoid bladder injuries) [2-4].