Trans Inguinal Peritoneal Technique (TIPP) Repair
Inguinal hernias, the most common type of hernias, are repaired using our "Tension-Free" procedure. This method addresses and reinforces the hernia-prone region called the Myopectineal Orifice of the groin. Tension-Free mesh reinforcement of the Myopectineal Orifice can also help prevent recurrences.
Our mini-incision, "open" technique, requires only mild sedation and local anesthesia for the majority of all hernia repairs. Surgeons make a small incision (about two inches in most patients).
Once the hernia (bulge) is freed up by gentle dissection, it is returned through the hole or weakness into its proper position. Rather than just covering the weakness at this point, a specially designed, sterile "mesh" system is gently placed through the defect. It is positioned to cover and effectively repair the defect from the inside. This mesh extends well beyond the edges of the defect to reduce pressure on the hernia defect opening, and reinforces the entire hernia-prone area (called the Myopectineal Orifice) at the same time. The mesh is held in place without tension. There is no need to place painful, tight sutures, staples or tacks to pull muscle unnaturally together. By utilizing mesh to reinforce the defect, suture-line tension used in other standard tissue-to-tissue repairs is eliminated with this technique, while fully preserving both the normal anatomic structure and physiologic functions of the inguinal area.
After this "underlay" mesh is properly positioned, an additional sheet of mesh is included over the defect to ensure reinforcement of the entire area. This mesh is also placed in a completely tension-free fashion, held in place by the mesh itself. Since there is no tension and only a small surgical dissection, post-operative pain is minimal and patients quickly return to normal activity. This technique has been utilized for more than 10 years, with recurrence rates of lower than one-half percent.
During surgery, patients remain awake, yet calm and sedated and comfortably free of pain, and avoid the risks of general anesthesia. Patients begin walking shortly after surgery, and are discharged home within two hours.
Tailored to the Patient
Our surgeons choose from several mesh systems to best match patients’ unique needs. Hernias differ from patient to patient, often quite significantly. One single tension-free operative approach or single mesh product system is not suitable for all patients or all hernias.
Tailoring the mesh or mesh product to the exact dimensions and needs of the patient is critically important for effective and safe hernia repair. Since some mesh products are not amenable to this type of tailoring, we choose only mesh products that permit us to provide exact, yet completely effective mesh coverage for hernia repair. This safe, effective product is utilized in the overwhelming majority of inguinal hernia repairs, including all primary (first time) repairs in adults, and over 95% of recurrent inguinal hernia repairs.
Surgeons at North Penn Surgical Associates perform various advanced Tension-Free repair techniques commonly used today, using a variety of mesh systems. We individually select the precise mesh product (selecting the precise size, shape, configuration and manufacturer) at the time of surgery that is best suited for each hernia. Our expertise in both routine and complex hernia surgery assures that all of our patients receive the most satisfactory, safest and importantly the most effective repair available.
Recovery is rapid, pain is minimal since muscles are not cut and are neither pulled together nor sewn under tension. Post-operative restrictions are few, if any, and our patients can actually return to their normal activity in a short period of time.
The advanced techniques we utilize are associated with a lower risk of recurrence when compared to most other older surgical techniques that place tension on the muscle and the repair by cutting and sewing muscle together. Our technique is equally safe and the fully effective for most recurrent hernias as well.
While the over-whelming majority of primary Inguinal hernias are both safely and effectively repaired using just local anesthesia and mild sedation, certain hernias (those that are large and/or complex, have recurred multiple times, or patients are extremely obese) or for certain patients, a safe, light form of mild general anesthesia under the supervision of a certified anesthesiologist may be required.
125 Medical Campus Drive
Lansdale, PA 19446