LAPAROSCOPIC ADHESIOLYSIS IN LAPAROSCOPIC TAPP HERNIOPLASTY IN COMBINATION WITH PERITONEAL DISEASE

Abstract. Aim. To substantiate the feasibility of performing laparoscopic adhesiolysis in laparoscopic TAPP hernioplasty in combination with abdominal conjunctival disease. Materials and Methods. The results of treatment of 21 patients who had previously undergone abdominal surgery and who underwent laparoscopic adhesiolysis as the first stage of surgery and laparoscopic hernioplasty using the TAPP technique as the second stage were analyzed. The results of laparoscopic adhesiolysis were evaluated 1 year after surgery, comparing the clinical signs that were present before surgery. Results. The results obtained indicate that in 57.9 % of patients whose pain syndrome regressed after surgery, the preoperative pain was caused by a conjugate disease of the abdominal cavity. A significant decrease in pain severity in 15.8 % of cases was most likely due to laparoscopic adhesiolysis and the occurrence of preoperative pain caused by a conjugative disease of the abdominal cavity. Preservation of pain syndrome in 26.3 % of patients can be regarded as the lack of effect of laparoscopic adhesiolysis, and a possible cause of preoperative pain not related to the abdominal cavity disease. Conclusions. Laparoscopic adhesiolysis during laparoscopic inguinal hernia repair shows significant potential for improving the results of treatment of patients with concomitant adhesive disease of the abdominal cavity, which allowed in 57.9 % of cases to avoid the development of pain associated with adhesive disease of the abdominal cavity after surgery and in 15.8 %, to significantly reduce the severity of pain.