Manejo de la hernia inguinal mediante TAPP (hernioplastia transabdominal preperitoneal)

Abstract

Introduction. It is estimated that between 10% and 15% of the world's population currently has or will have a hernia in the abdominal wall, with 60% of these hernias being specifically in the inguinal region and with a lifetime risk of suffering an inguinal hernia between 27% to 43% in men. Minimally invasive surgery, including inguinal hernioplasty, has become one of the most common surgical procedures worldwide. Currently, the laparoscopic technique has become an option for the repair of hernia pathology. The results have been favorable due to the use of tension-free meshes. Objective. To describe the management of inguinal hernias by means of the preperitoneal transabdominal laparoscopic technique. Methodology. A narrative bibliographic review of systematic reviews, meta-analyses, and bibliographic reviews in English and Spanish, compiled in databases such as PubMed, LILACS and Medline, published in the last 5 years in humans older than 65 years, was carried out. Results. This analysis addressed the approach to inguinal hernia management in older adults through the technique of transabdominal preperitoneal hernioplasty, based on the review and analysis of 15 studies, following the application of inclusion and exclusion criteria. The studies provided substantial data regarding various complications such as seroma, hematoma, and wound infection. Additionally, less common complications were explored, and the advantages and disadvantages of employing this technique were evaluated, also considering the impact in terms of costs and length of hospital stay. This comprehensive analysis provides an essential perspective on the effectiveness and feasibility of transabdominal preperitoneal hernioplasty in the older adult population. Conclusion. Preperitoneal transabdominal hernioplasty offers positive results in patient recovery, less postoperative pain, and a significantly reduced probability of infections, allowing an early return to daily activities and work. However, late complications may arise, such as chronic groin pain and hernia recurrence.