الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Aim of the work to evalute the role of laraoscopy in the repair of the different types of inguinal hernias ,including its Advantages and disdvantages in comparison with open inguinal hernia repair.Much evidence suggests that hernia formation and Recurrence depends in part on a systemic predisposition due to an abnormal metabolism of connective tissue and in part on other Risk factors, surgical as well as non-surgical. (Sorenson et al., 2002)Inguinal hernia repair is the most frequently performed Operation in general surgery with about 100,000 procedures being carried out in the UK, 700,000 in the US and 20 million worldwide Annually. (Kruzer and Kark, 2005).In the last 15 years the development and refinement of new techniques and assimilation of new and evolving medical technologies has turned laparoscopic inguinal hernia repair from an experimental to a widely performed procedure. Further improvements in prosthetic mesh technologies and new methods of mesh fixation are now expanding the role of laparoscopy to other types of hernia (Ahmed and Beckingham, 2004).Early laparoscopic inguinal hernia repair techniques such as simple ring closure or intraperitonial onlay of mesh (IPOM) had high rates of recurrence and complications and have been superseded. The two current methods are Trans-Abdominal Pre-Peritoneal (TAPP) and Totally Extraperitoneal (TEP) repair. TEP is considered to be technically more difficult, partly because of unfamiliarity with the anatomy. The use of a balloon can greatly facilitate dissection, particularly useful for surgeons on the early part of their learning curve, although it does add to the cost of the procedure (National Institute for Clinical Excellence, 2001).A large European Union meta-analysis recently compared the results of minimally invasive hernia repair with the traditional open mesh repair. This meta analysis compared the results of 41 published trials .The conclusion was that the risks of haematoma formation and wound infection were less in the laparoscopic group. The duration of hospital stay was less and return to normal activity was quicker after laparoscopic surgery. The incidences of chronic pain, numbness and hernia recurrence were also less after laparoscopic repair. The incidence of haematoma formation was less after laparoscopic repair but of seroma formation was hi (Mc Cormack, 2003).
The laparoscopic approach also often identifies additional hernias, some of which might well not have been seen at open surgery (Crawford et al., 1998).The UK National Institute of Clinical Excellence(NICE) published the guidelines on laparoscopic hernia repair including that: for repair of primary inguinal hernia, open (mesh) should be the preferred surgical procedure; for the repair of recurrent and bilateral inguinal hernia, laparoscopic surgery should be considered; when laparoscopic surgery is undertaken for inguinal hernia, the TEP procedure should be preferred; laparoscopic surgery for inguinal hernia should be only undertaken in those units with appropriately trained operating teams that regularly undertake these procedures (National Institute for Clinical Excellence, 2001).the riskAim of the Work This study aims to evaluate the role of laparoscopy in the repair of the different types of inguinal hernias, including its advantages and disadvantages in comparison with open inguinal hernia repair.