DOI: http://dx.doi.org/10.18203/2349-2902.isj20204954

A prospective randomized comparison of short-term outcome of laparoscopic, totally extra-peritoneal and trans-abdominal pre-peritoneal repairs for inguinal hernia

Saurabh Kumar, Manmeet Kaur

Abstract


Background: Laparoscopic repair of inguinal hernia is steadily gaining popularity among general surgeons. Laparoscopically the preperitoneal space can be approached in two different ways, as a result of which two techniques of laparoscopic repair have emerged. We performed this study to compare the two techniques in a randomized setting in order to ascertain, if possible, which of these techniques is preferable when there is a choice.  

Methods: This randomized, comparative study was conducted at Shri Mahant Indiresh hospital, Dehradun over a period of three years. Patients with unilateral, uncomplicated, inguinal hernia were randomized into two groups for undergoing surgery using either of these techniques. Patients’ demography and both intraoperative and postoperative variables were compared between the two groups.

Results: Mean duration of surgery and mean pain scores in early postoperative period were found to be higher for transabdominal preperitoneal (TAPP) group as compared to totally extraperitoneal (TEP) group. Intraoperative and postoperative complications as well as hospital stay were not significantly different between the two groups.

Conclusions: In this study TEP has been found to have an edge over TAPP in some respect but as per the available evidence both techniques are safe and choice of procedure may be tailored according to individual cases.  


Keywords


Totally extraperitoneal, Transabdominal preperitoneal, Inguinal hernia

Full Text:

PDF

References


Bansal VK, Krishna A, Misra MC, Kumar S. Learning Curve in Laparoscopic Inguinal Hernia Repair: Experience at a Tertiary Care Centre. Ind J Surg. 2016;78(3):197-202.

Light D, Stephenson BM, Sanders DL; British Hernia Society. Management of the uncomplicated primary inguinal hernia in 2019: the practice amongst members of the British Hernia Society. Ann R Coll Surg Engl. 2020;102(3):191-3.

Köckerling F, Simons MP. Current Concepts of Inguinal Hernia Repair. Visc Med. 2018;34(2):14550.

Soler, M. The minimal open preperitoneal (MOPP) approach to treat the groin hernias, with the history of the preperitoneal approach. Ann Laparosc Endosc Surg. 2017;2(8).

Cueto J, Vázquez JA, Solís MA, Valdéz G, Valencia S, Weber A. Bowel obstruction in the postoperative period of laparoscopic inguinal hernia repair (TAPP): review of the literature. J Soc Laparosc. 1998;2(3):277-80.

Köhler G, Mayer F, Lechner M. Small bowel obstruction after TAPP repair caused by a self–anchoring barbed suture device for peritoneal closure: Case report and review of the literature. Hern. 2015;19(3):389-94.

Rambhia SU, Modi R. A comparative study between totally extraperitoneal and transabdominal preperitoneal laparoscopic inguinal hernia repair techniques. Int Surg J. 2017;4(2):663-70.

Vărcuş F, Duţă C, Dobrescu A, Lazăr F, Papurica M, Tarta C. Laparoscopic Repair of Inguinal Hernia TEP versus TAPP. Chirurgia (Bucur) 2016;111(4):308-12.

More MP, Nasta AM, More RM, Shedge R. Comparison of Laparoscopic TAPP (Transabdominal Preperitoneal) and Laparoscopic TEP (Totally Extra peritoneal) Techniques for Inguinal Hernia Repair- An Observational Study of 60 Cases. J Dent Medic Sci. 2016;15(7):90-3.

Krishna A, Misra MC, Bansal VK, Kumar S, Rajeshwari S, Chabra A. Laparoscopic inguinal hernia repair: transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) approach: a prospective randomized controlled trial. Surg Endosc. 2012;26(3):639-49.

Gass M, Banz VM, Rosella L, Adamina M, Candinas D, Güller U. TAPP or TEP? Population-based analysis of prospective data on 4,552 patients undergoing endoscopic inguinal hernia repair. World J Surg. 2012;36(12):2782-6.

Bracale U, Melillo P, Pignata G, Di Salvo E, Rovani M, Merola G et al. Which is the best laparoscopic approach for inguinal hernia repair: TEP or TAPP? A systematic review of the literature with a network meta-analysis. Surg Endosc. 2012;26(12):3355-66.

Gass M, Scheiwiller A, Sykora M, Metzger J. TAPP or TEP for Recurrent Inguinal Hernia? Population-Based Analysis of Prospective Data on 1309 Patients Undergoing Endoscopic Repair for Recurrent Inguinal Hernia. World J Surg. 2016;40(10):2348-52.

Chen LS, Chen WC, Kang YN, Wu CC, Tsai LW, Liu MZ. 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(2):418-28.

Wei FX, Zhang YC, Han W, Zhang YL, Shao Y, Ni R. Transabdominal Preperitoneal (TAPP) Versus Totally Extraperitoneal (TEP) for Laparoscopic Hernia Repair: A Meta-Analysis. Surg Laparosc Endosc Percutan Tech. 2015;25(5):375-83.

Aiolfi A, Cavalli M, Micheletto G, Lombardo F, Bonitta G et al. Primary inguinal hernia: systematic review and Bayesian network meta-analysis comparing open, laparoscopic transabdominal preperitoneal, totally extraperitoneal, and robotic preperitoneal repair. Hern. 2019;23(3):473-84.

Köckerling 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(12):3750-60.

Chowbey PK, Pithawala M, Khullar R, Sharma A, Soni V, Baijal M. Complications in groin hernia surgery and the way out. J Minim Access Surg. 2006;2(3):174-7.

Tolver MA, Rosenberg J, Bisgaard T. Early pain after laparoscopic inguinal hernia repair. A qualitative systematic review. Acta Anaesthesiol Scand. 2012;56(5):549-57.

Bansal VK, Misra MC, Babu D, Victor J, Kumar S, Sagar R et al. A prospective, randomized comparison of long-term outcomes: chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surg Endosc. 2013;27(7):2373-82.