I am wondering,what are the advantages and downsides of each procedure? Is one recommend in certain cases? Mind you I want a tissue only but I don’t know I can get one other than a shouldice whatever the hernia type might be…
TEP has a lower chance of intestinal adhesion because the peritoneum is not breached. Totally EXTRA-Peritoneal. Meaning completely outside of the peritoneum, where the intestines are.
TAPP surgeons like TAPP because they can see more before they decide to open the peritoneum and place the mesh, I think. There is a series of SAGES educational videos that describe the methods, with some comparison.
Don’t overlook that many laparosocpic surgeons like the method because it leaves fewer scars. If you search “minimally invasive” on the internet you’ll find “scar-free” used as a selling point. TEP surgeons go in through the navel so when they ‘re done the abdomen looks almost untouched from the outside. But on the inside the peritoneum is peeled almost completely from the abdominal wall to make room for the mesh. Blunt dissection is a peeling or splitting of the two layers to create that space for the mesh.
The small entry points do heal faster and I think that there is less chance of the incision splitting open later, leading to an incisional hernia. It seems like a fantastic method for gall bladder removal or appendectomy, which is where it saw a lot of development, as I understand things.
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