DOI: http://dx.doi.org/10.18203/2349-2902.isj20184651

Laparoscopic inguinal hernia repairs: comparison between TAPP and TEP at a tertiary center of Nepal

Komal B. Gurung, Niroj Banepali, Rakesh R. Sthapit, Baikuntha Adhikari

Abstract


Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.

Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.

Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.

Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.


Keywords


Inguinal hernia, Laparoscopic, TAPP, TEP, Comparison

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References


Mark AM, Michael JR. Hernias. In: Townsend CM, Beauchamp RD, Evers BM, eds: Sabiston textbook of Surgery, 20th ed. Philadelphia: Elsvier;2017:1092-1119.

Kingsnorth A, LeBlanc K. hernias: inguinal and incisional. Lancet. 2003;362:1561-71.

Davis CJ, Arregui ME. Laparoscopic repair for groin hernias. Surg. Clin. North. Am. 200;83:1141-61.

Krishna A, Mishra MC, Bansal VK, Kumar S, Rajeshwari S, Chabra A. Laparoscopic inguinal hernia repair: transabdominal preprotoneal (TAPP) versus totally extraperitoneal (TEP) approach: a prospective randomized controlled trial. Surg Endosc. 2012;26:639-49.

Choksi D, Parmar A, Raiyani G, Prasad G. Comparative prospective study of laparoscopic TEP repair versus laparoscopic TAPP repair for inguinal hernioplasty conducted at tertiary level hospital, Vadodara. Int J Res Med. 2014;3(1):17-9.

Abd Al-Rahman MHN, Abd El-Latif TE, Wael El said L. Transabdominal preperitoneal and totally extraperitoneal laparoscopic inguinal hernia repair: a comparative study. ZUMJ. 2016:22(1):48-61.

Bansal VK, Krishna A, Mishra MC, Kumar S. Learning curve in laparoscopic inguinal hernia repair: experience at a tertiary care center. Indian J Surg. 2016;78(3):197-202.

Gong K, Zhang N, Lu Y, Zhu B, Zhang Z, Du D, et al. Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal hernia repair: a prospective randomized controlled trial. Surg Endosc. 2011;25:234-9.

More MP, Nasta AM, More RM, Shedge R. Comparison of laparoscopic TAPP (transabdominal preperitoneal) and laparoscopic TEP (totally extraperitoneal) techniques for inguinal hernia repair: an observational study of 60 cases. ISOR-JDMS. 2016;15(7):90-3.

Günal Ö, Özer Ş, Gürleyik E, Bahçebaşi T. Does the approach to the groin make a difference in hernia repair? Hernia. 2007;11:429-34.

Feng B, He Z-R, Li J-W, Ling T-L, Zhang Y, Chen Z, et al. Feasibility of incremental laparoscopic inguinal hernia repair development in China: An 11-year experience. J Am Coll Surg. 2013;216:258-65.

Hamza Y, Gabr E, Hammadi H, Khalil RF. Authors arm randomized trial comparing laparoscopic and open hernia repairs. Egypt J Surg. 2009;28(3):110-7.

Kumar P, Kumar N. Transabdominal preperitoneal versus totally extraperitoneal laparoscopic techniques for inguinal hernia repair: a comparative study. Int Surg J. 2017;4:162-5.

Zeineldin A. Transabdominal (TAPP) versus total extraperitoneal (TEP) laparoscopic inguinal hernia repair: a prospective comparative study. Minut Med J. 2008;21:147-54.

Rambhia SU, Modi R. A comparative study between totally extraperitoneal and transabdominal preperitoneal laparoscopic inguinal hernia techniques. Int Surg J. 2017;4:663-70.

Shpitz B. Lansberg L, Bujayev N, TiomkinV, Klein E. Should peritoneal tears be routinely closed during laparoscopic totally extraperitoneal repair of inguinal hernias? A reappraisal. Surg Endosc. 2004;18:1771-3.

Bansal VK, Krishna A, Mishra MC, Kumar S. Learning curve in laparoscopic inguinal hernia repair: experience at a tertiary care center. Indian J Surg. 2016;78:197-202.

Gurung KB, Adhikari B, Thapa GS, Upadhyay P. Laparoscopic inguinal hernia repair (TAPP): early and medium-term results. Int J Health Sci Res. 2017;7(12):68-74.

Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant A. Transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. The Cochrane Library. 2008;4:1-25.

Verma N, Prajapati K, Mistry S. A comparative study between total extraperitoneal (TEP) repair and transabdominal preperitoneal (TAPP) repair in management of inguinal hernia. Nation J Med Res. 2015;5:64-6.

Bringman S, Ek A, Haglind E, Heikkinen T, Kald A,Kylberg F. Is a dissection ballon beneficial in totally extraperitoneal endoscopic hernioplasty (TEP)? a randomized prospective multicenter study. Surg Endosc. 2001;15:266-70.