Choice of surgical tactics for anterior abdominal wall hernias: traditional hernioplasty or eTEP-hernioplasty

Objective: To evaluate and compare the effectiveness of two methods of surgical treatment of hernias of the anterior abdominal wall - traditional hernioplasty with tissue tension and modern minimally invasive eTEP- (endoscopic total extraperitoneal) hernioplasty. Materials and Methods: The study included 60 patients with anterior abdominal wall hernias undergoing surgical treatment, of whom 38 (63.3%) were men and 22 (36.7%) were women. The average age of men was 50.2±11.3 years, while the average age of women was 48.1±9.6 years. All patients were randomized into two equal groups of 30 patients each. One group underwent traditional hernia repair, while the other underwent the eTEP procedure. Results: Over 93% of patients who underwent eTEP hernioplasty reported a high level of satisfaction with the treatment results: painlessness, cosmetic results, and rapid recovery. In the traditional hernioplasty group, this figure was 70%. In Group 1, postoperative complications occurred in 8 patients (26.7%), including seromas, infiltrates, and local inflammatory reactions; in Group 2, they occurred in 2 patients (6.7%). During 6 months of observation, relapse was recorded in 5 patients (16.7%) in group 1, and in one case (3.3%) in group 2. Pain on the third day (as measured by the visual analog scale, VAS) was 1.7 times greater in patients in Group 1 (5.1 vs. 2.9, p<0.01). In Group 2, pain lasted an average of 3 days less (p<0.01). The recurrence rate in Group 1 was 20%, while in Group 2 this rate decreased to 3%, with a significant improvement in the blood flow to the anterior abdominal wall. Conclusion: The study results convincingly demonstrate the high efficacy and safety of eTEP hernia repair compared to traditional methods for treating anterior abdominal wall hernias in elderly patients. eTEP hernia repair is characterized by fewer complications, a low recurrence rate, faster recovery, and significantly reduced postoperative pain.