Trans abdominal pre-peritoneal versus totally extra-peritoneal laparoscopic techniques for inguinal hernia repair: a comparative study

Praveen Kumar; Nilkamal Kumar

doi:10.18203/2349-2902.isj20164299

Authors

Praveen Kumar Department of Surgery, SGRRIMHS and SMIH, Dehradun, Uttarakhand, India
Nilkamal Kumar Department of Surgery, SGRRIMHS and SMIH, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2349-2902.isj20164299

Keywords:

Inguinal hernia, TAPP, TEP

Abstract

Background:Laparoscopic inguinal hernia repair has been controversial as far as the choice of approach is considered. Laparoscopy has obvious advantages over the open technique. TAPP and TEP are the most common laparoscopic approaches. A multitude of research data is available on these, but, evidence based medicine does not allow conclusions to be drawn about the relative effectiveness of TEP compared with TAPP. The scarcity of data about the relative merits and risks of both the methods induced the need to undertake this study.

Methods: The study was undertaken for patients admitted in surgery department in a single unit who underwent laparoscopic inguinal hernia repair, either TAPP or TEP, after appropriate patient selection and counseling. 40 patients were assessed in the study between May 2014- May 2016.

Results:In our study we found both TAPP and TEP to be safe and feasible options for inguinal hernia repair. TAPP could be the preferred option as it allows visualization and simultaneous repairs of clinically undiagnosed contra-lateral defects.

Conclusions:We concluded in this study that laparoscopic inguinal hernia repair may safely be offered to properly selected patients. TAPP and TEP fair equally well in terms of operative time, intra and postoperative complications and patient recovery. TAPP is a better technique as it allows intra-operative diagnosis and repair of previously undiagnosed contra-lateral hernia.

Metrics

Metrics Loading ...

References

Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzil GS, Fitzgibbons RJ, et al. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia. International Endohernia Society (IEHS). Surg Endosc. 2011;25:2773-843.

The EU Hernia Trialists Collaboration. Laparoscopic versus open groin hernia repair: meta-analysis of randomized trials based on individual patient data. Hernia. 2002;6:2-10.

Ferzil G, Masaad A, Albert P, Worth MH. Endoscopic extraperitoneal herniorrhaphy versus conventional hernia repair. A comparative study. Curr Surg. 1993;50:291-4.

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

McCormack K, Wake BL, Fraser C, L Vale, Perez J, Grant A. Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review. Hernia. 2005;9:109-14.

Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant A. Trans-abdominal pre-peritoneal repair (TAPP) versus totally extra peritoneal (TEP) laparoscopic techniques for inguinal hernia repair (Review). Cochrane Database of Systematic Reviews. 2005;1:Article No. CD004703.

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

Dulucq JL. Treatment of inguinal hernias by inserting a subperitoneal prosthetic patch using pre-peritoneoscopy (with a video film). Chirurgie: Memoirs de l’Academie de Chirurgie. 1992;118(1-2):83-5.

Leibl BJ, Jager C, Kraft B, Kraft K, Shwarz J, Ulrich M, et al. Laparoscopic hernia repair - TAPP or/& TEP? Langenbeck Arch Surg. 2005;390(2):77-82.

Kockerling F, Bittner R, Jacob DA, Seidelmann L, Keller T, Adolf D, et al. TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surg Endosc. 2015;29:3750-60.