Total extraperitoneal hernioplasty
The total extraperitoneal hernia repair ( TEP , Total Extraperitoneal plastic; also TEPP , Transcutaneous Endoscopic Promesh plastic) is a variant of the hernia operation.
technology
In the TEP technique is about two to three smaller cuts in minimally invasive surgical technique (MIC; keyhole surgery ) a tummy mirroring but not abdominal cavity mirror ( laparoscopy ) carried out in contrast to the TAPP technique ( T rans a bdominale P räperitoneale P atch-plastic). The main access is through a small incision, usually a little below the navel, through which the folded mesh can also be inserted. The thin plastic net ( Promesh ; mostly made of polypropylene) is inserted between the layers of the abdominal wall, i.e. behind the muscles and on the peritoneum , and thus permanently strengthens the abdominal wall. The net is fixed by the internal pressure of the abdomen and the counter-pressure of the abdominal muscles. It is important that the gap is covered over a large area so that the sum of all force vectors outside the gap is greater than the sum of the force vectors over the fracture gap. In most cases, no additional fastenings with clips made of metal or plastic are necessary.
In most cases, immediate resilience can be expected after TEP treatment, i. H. Less stressful everyday activities are possible.
