DOI: http://dx.doi.org/10.18203/2349-2902.isj20201393

Open and laparoscopic transabdominal preperitoneal approach for inguinal hernia: our single institution experience

Bhushankumar A. Thakur, Vivek Mukhamale, Snehal Deotale

Abstract


Background: Trans abdominal preperitoneal (TAPP) a novel approach for inguinal hernia was introduced by Arregui (1991) and Dion in early 1990’s has brought the revolutionary change in the era of hernia surgery over open preperitoneal inguinal hernia repair procedure introduce by Stoppa. Based on this we have done single institution retrospective study of TAPP and open preperitoneal procedure for inguinal hernia.

Methods: This study was single institution retrospective study, where we have analyzed the data of 93 male and 7 female patients out of which 50 underwent standard TAPP procedure and 50 patients who underwent open preperitoneal procedure for inguinal hernia, with median 1 year of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.

Results: 100 patients with mean age of 55 years, median ASA of 1, ratio of left: right: bilateral for open 18:30:2 and for laparoscopic 26:20:4. Mean time for surgery was 102.3 min for open and 142.4 mins for TAPP. There was surgical site infection in 3 patients operated by open procedure and 2 patients in TAPP procedure. 4 patients from open procedure group and no one with TAPP group developed seroma which were managed conservatively and resolved at 6 weeks and 8 weeks. One recurrence in TAPP group patient at the 1 week follow.

Conclusions: Open preperitoneal repair is hence a technique as effective as laparoscopic hernia repair with a minimal learning curve, ability to be performed under regional anaesthesia and cost effective. It can hence be used to carry out inguinal hernia repairs effectively in rural areas. 


Keywords


Inguinal hernia, Laparoscopy, TAPP

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References


Wright D, Dwyer PJ. The learning curve for laparoscopic hernia repair. Semin Laparosc Surg. 1998;5:227-32.

Cormack K, Wake B, Perez J. Systematic review of the clinical effectiveness and cost-effectiveness of laparoscopic surgery for inguinal hernia repair. Health Technol Assess. 2004;15:84-8.

Goodwin JS, Traverso LW. A prospective cost and outcome comparison of inguinal hernia repairs: laparoscopic transabdominal preperitoneal versus open tension-free preperitoneal. Surg Endosc. 1995;9:981-3.

Payne JH, Grininger LM, Izawa MT. Laparoscopic or open inguinal herniorrhapy? a randomised prospective trial. Arch Surg. 1994;129:973-81.

Leil B, Dauber P, Schwarz J. Standardised laparoscopic hernioplasty vs. shouldice repair result of a randomised comparative study. Chirurgie. 1996;67:465-6.

Amid PK, Shulman AG, Lichtenstein IL. The lichtenstein tension-free mesh repair of inguinal hernias. Surg Today. 1995;25:619-25.

Bittner R, Schmedt CG, Schwarz J, Kraft K, Leibl BJ. Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg. 2002;89(8):1062-6.

Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989;157(2):188-93.

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1e12.

Johansson B, Hallerbackk B, Glise H, Anesten B. Laparoscopic mesh versus open preperitoneal mesh for inguinal hernia repair: a randomized multicenter trial (SCUR: hernia repair study). Ann Surg. 1999;230(2):225.

Tanphiphat C. Laparoscopic vs open inguinal hernia repair. Surg Endoscopy. 1998;12:846-51.

Gohel J, Patel U. Prolene hernia system in the tension free repair of primary inguinal hernias. National J Med Res. 2012:2(3):302-5.

Stoker DL, Spiegelhalter DJ, Wellwood JM. Laparoscopic versus open inguinal hernia repair: randomised prospective trial. Lancet. 1994;343:1243-5.

Maddern GJ, Rudkin G, Bessell JR, Devitt P, Ponte L. A comparison of laparoscopic and open hernia repair as a day surgical procedure. Surg Endosc. 1994;8:1404-8.

Lawrence K, Whinnie D, Goodwin A, Doll H, Gordon A, Gray A, et al. Randomised controlled trial of laparoscopic versus open repair of inguinal hernia: early results. BMJ. 1995;311:981-5.

Leibl B, Daubler P, Schwarz J, Ulrich M, Bittner R. Standardised laparoscopic (TAPP) versus shouldice repair of inguinal hernia. Results from a prospective randomised and controlled trial. Chirurg. 1995;66:895-8.

Barkun JS, Wexler MJ, Hinchey EJ, Thibeault D, Meakins JL. Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomised controlled trial. Surg. 1995;118:703-10.

Vogt DM, Curet MJ, Pitcher DE, Martin DT, Zucker KA. Preliminary results of a prospective randomised trial of laparoscopic only versus conventional inguinal herniorrhaphy. Am J Surg. 1995;169:84-90.

Hauters P, Meunier D, Urgyan S, Jouret JC, Janssen P, Nys JM. Prospective randomised study comparing laparoscopy and shouldice technique in the treatment of unilateral inguinal hernia. Ann Chir. 1996;50:776-81.

Wright DM, Kennedy A, Baxter JN, Fullarton GM, Fife LM, Sunderland GT, et al. Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial. Surg. 1996;119:552-7.

Neumayer L, Hurder AG, Johansson O. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004;350:1819-27.

Wellwood J, Sculpher MJ, Stoker D. Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ. 1998;317(7151):103-10.