Tigora Anca, Radu Petru Adrian, Garofil Dragos Nicolae, Bratucu Mircea Nicolae, Zurzu Mihai, Paic Vlad, Ioan Raluca Gabriela, Surlin Valeriu, Margaritescu Dragos, Badoiu Silviu Constantin, Popa Florian, Strambu Victor, Ramboiu Sandu
Tenth Department of Surgery, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
Department of Gynecology, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
J Clin Med. 2025 Jul 9;14(14):4875. doi: 10.3390/jcm14144875.
Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide, with over 20 million cases annually. The evolution of hernia surgery has transitioned from tension-based techniques to tension-free approaches, significantly reducing recurrence rates. This review explores the history, advancements, and current trends in minimally invasive inguinal hernia repair, focusing on laparoscopic techniques such as transabdominal preperitoneal (TAPP), totally extraperitoneal (TEP), single-incision laparoscopic surgery (SILS), and robotic-assisted repair. The importance of prosthetic meshes is emphasized, detailing their mechanical properties, pore size, weight classifications, and biocompatibility. Additionally, various mesh fixation methods-including tacks, sutures, and glues-are analyzed, with a discussion on their impact on postoperative complications such as chronic pain, adhesions, and infection risk. The debate between TAPP and TEP techniques is examined, highlighting the ongoing quest to determine the most effective approach. Emerging advancements, including drug-loaded meshes and dual-layered prosthetics, aim to improve integration and reduce complications. Despite significant progress, no universally superior technique or mesh exists, underscoring the need for individualized surgical approaches. Future research should focus on optimizing materials, refining fixation strategies, and enhancing patient outcomes in minimally invasive hernia repair.
腹股沟疝修补术是全球最常开展的外科手术之一，每年病例超过2000万例。疝手术的发展已从基于张力的技术转变为无张力方法，显著降低了复发率。本综述探讨了微创腹股沟疝修补术的历史、进展和当前趋势，重点关注腹腔镜技术，如经腹腹膜前修补术（TAPP）、完全腹膜外修补术（TEP）、单切口腹腔镜手术（SILS）和机器人辅助修补术。强调了人工补片的重要性，详细介绍了其力学性能、孔径、重量分类和生物相容性。此外，分析了各种补片固定方法，包括钉合、缝合和胶水，并讨论了它们对术后并发症（如慢性疼痛、粘连和感染风险）的影响。探讨了TAPP和TEP技术之间的争论，突出了确定最有效方法的持续探索。包括载药补片和双层假体在内的新兴进展旨在改善整合并减少并发症。尽管取得了重大进展，但不存在普遍优越的技术或补片，这突出了个性化手术方法的必要性。未来的研究应专注于优化材料、完善固定策略以及改善微创疝修补术的患者预后。
