A hernia is a medical condition in which internal organs or parts of them protrude beyond their normal anatomical position through openings or weakened areas in the body walls. Hernias most commonly occur in the abdominal cavity, but can also form in other parts of the body.

HERNIA TREATMENT TECHNIQUES
TAPP (Transabdominal Preperitoneal Hernioplasty)
A method for treating inguinal hernias in which a mesh is placed in the preperitoneal space through the abdominal cavity, typically via three punctures. TAPP is indicated for patients with direct, indirect, combined, and recurrent inguinal and umbilical hernias. The method is effective for bilateral hernias and is particularly suitable for patients who lead an active lifestyle or have occupational demands involving physical exertion.

eTEP (extended Totally Extraperitoneal Hernioplasty)
A method for hernia repair, including inguinal, femoral, and suprapubic hernias, as well as cases after previous open surgeries in the lower abdominal cavity. The mesh is placed preperitoneally without entering the abdominal cavity, which prevents the formation of adhesions and damage to abdominal organs. The eTEP technique can be performed in patients with extreme forms of obesity, is feasible for inguinoscrotal hernias, and eliminates postoperative adhesions in the abdominal cavity.

STAGES OF TAPP PROCEDURE
The operation begins with general anesthesia. After creating pneumoperitoneum, laparoscopic instruments are introduced into the abdominal cavity through trocars. In the first stage, the surgeon visualizes the inguinal region from the inside and determines the exact location of the hernia sac. The peritoneum is then carefully incised in the area of the medial inguinal fossa, providing access to the preperitoneal space.

An important task is the dissection of the hernia sac and the release of the spermatic cord elements or the round ligament of the uterus in women. After preparing the space, a synthetic mesh — a polypropylene or composite endoprosthesis — is placed into it. The mesh is placed without tension, covering potential areas of the hernia defect, which ensures reliable prevention of recurrence.
The operation is completed by suturing the peritoneum, which prevents contact of the mesh with internal organs and reduces the risk of adhesion formation. The entire procedure typically takes 30–60 minutes and is performed using modern high-definition video technology, which enhances the precision of surgical manipulations.


STAGES OF eTEP PROCEDURE
Access — a 10-mm skin incision is made in the left mesogastrium, parasternal (pararectal) region. Using an optical Visiport device or an open method, access to the retromuscular space is achieved, and a 10-mm trocar is inserted.
Rectus muscle separation — using a laparoscope, the left rectus muscle is bluntly separated from the posterior layer of its sheath. Under visual control, a 5-mm trocar is inserted in the umbilical region.
Closure of the hernia defect.

Closure of rectus abdominis diastasis (if necessary).
Placement of mesh prostheses in the retromuscular space without fixation (a macroporous mesh endoprosthesis measuring up to 30×30 cm is typically used, inserted through a 12-mm trocar).
Placement of a drain in the operative area, connected to a J-VAC system.
Removal of trocars, desufflation, and suturing of puncture sites.
Equipment and instruments used in laparoscopy:
For laparoscopic hernia repair (hernioplasty), a high-tech equipment complex is used:
laparoscopic tower/stack (monitor, camera, insufflator, light source)

For hernia repair (hernioplasty), the following set of laparoscopic instruments is used:
trocars (5–10 mm)
laparoscopes with camera
graspers
scissors
dissectors
electrocautery device (monopolar or bipolar) for hemostasis, etc.