Intraoperative and postoperative complications in transabdominal preperitoneal versus totally extraperitoneal laparoscopic inguinal hernia repair: a prospective randomized controlled trial
DOI:
https://doi.org/10.18203/2349-2902.isj20261170Keywords:
Laparoscopic inguinal hernia repair, TAPP, TEP, ComplicationAbstract
Background: Laparoscopic inguinal hernia repair has gained widespread acceptance due to reduced postoperative pain, improved recovery, and favorable cosmetic outcomes. Among laparoscopic approaches, transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair are the most commonly employed techniques. However, comparative evidence regarding intraoperative and postoperative complication profiles remains variable.
Methods: This prospective randomized controlled trial was conducted in the Department of General Surgery at Mahatma Gandhi Medical College and Hospital from April 2024 to September 2025. Sixty patients with inguinal hernia were randomized into TAPP (n=30) and TEP (n=30) groups. Postoperative pain was assessed using the visual analogue scale (VAS), and patients were followed for six months.
Results: The mean operative time was significantly shorter in the TAPP group (60.97±11.41 minutes) compared to the TEP group (69.37±11.25 minutes; p=0.006). Early postoperative pain at 6 and 12 hours was significantly lower in the TEP group (p<0.05). Incidence of edema, urinary retention, hematoma, chronic pain, and recovery outcomes were comparable.
Conclusions: Both TAPP and TEP are safe and effective laparoscopic techniques with comparable complication profiles. TAPP offers shorter operative time, whereas TEP provides reduced immediate postoperative pain. Long-term outcomes are equivalent.
References
Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence and trends. Int J Epidemiol. 1996;25(4):835-9.
Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. Tension-free hernioplasty. Am J Surg. 1989;157(2):188-93.
McCormack K, Scott NW, Go PM, Ross S, Grant AM. Laparoscopic techniques vs open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785.
Arregui ME, Davis CJ, Yucel O, Nagan RF. Laparoscopic inguinal hernia repair. Surg Clin North Am. 1993;73(3):513-29.
Bittner R, Montgomery MA, Arregui E, Bansal VK, Bingener J, Bisgaard T, et al. International guidelines for groin hernia management. Hernia. 2018;22(1):1-65.
Aiolfi A, Cavalli M, Micheletto G, Bruni PG, Lombardo F, Bonitta G, et al. TAPP vs TEP systematic review and trial sequential analysis. Surg Endosc. 2021;35(7):3534-46.
Krishna A, Misra MC, Bansal VK, Kumar S, Rajeshwari S, Chabra A. Randomized trial of TAPP vs TEP. Surg Endosc. 2012;26(3):639-49.
Manangi M, Shivashankar S, Vijayakumar A. Chronic pain after inguinal hernia repair. Int J Surg. 2014;12(5):402-5.
Schulz KF, Altman DG, Moher D. CONSORT statement. Lancet. 2010;375(9721):1132-7.
Chen LS, Chen WC, Kang YN. Effects of transabdominal preperitoneal and totally extraperitoneal inguinal hernia repair: an update systematic review and meta-analysis of randomized controlled trials. Surg Endosc. 2019;33:418-28.
Wei FX, Zhang YC, Han W, Zhang YL, Shao Y, Ni R. Meta-analysis of randomized trials comparing TAPP vs TEP. Surg Laparosc Endosc Percutan Tech. 2015;25(5):375-83.
Köckerling F, Bittner R, Jacob DA, Seidelmann L, Keller T, Adolf D, et al. Registry-based comparison of TAPP vs TEP. Surg Endosc. 2015;29(12):3750-60.
Bracale U, Melillo P, Pignata G, Di Salvo E, Rovani M, Merola G, et al. Network meta-analysis of laparoscopic hernia repair. Surg Endosc. 2012;26(12):3355-66.
Kukleta JF. Causes of recurrence in laparoscopic hernia repair. J Minim Access Surg. 2006;2(3):187-91.
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