Does Peritoneal Flap Closure Technique Following Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair Make a Difference in Postoperative Pain? A Long-term Quality of Life Comparison

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2016 Dec 8

PMID 27924394

Citations 9

Authors

Samuel W Ross

Steven A Groene

Tanu Prasad

Amy E Lincourt

Kent W Kercher

Vedra A Augenstein

B Todd Heniford

Affiliations

Soon will be listed here.

Abstract

Background: Transabdominal, preperitoneal (TAPP), laparoscopic inguinal hernia repair (IHR) requires the creation of a peritoneal flap (PF) that must be closed after mesh placement. Our previous study indicated that sutured PF closure resulted in less short-term postoperative pain at 2 and 4 weeks compared to tacks and staples. Therefore, the aim of this follow-up study was to compare short-term QOL with a greater sample size and long-term QOL at 2 years by method of PF closure.

Materials And Methods: A prospective institutional hernia-specific database was assessed for all adult TAPP IHRs from July 2012 to May 2015. QOL outcomes were compared by PF closure method at 2 and 4 weeks and 6, 12, and 24 months as measured by the Carolinas Comfort Scale. Standard statistical tests were used for the whole population and then the Bonferroni Correction was used to compare groups (p < 0.0167). Multivariate analysis controlling for age, gender, recurrent hernias, and preoperative symptomatic pain was used to compare QOL by PF closure method.

Results: A total of 679 TAPP IHRs in 466 patients were analyzed; 253 were unilateral, and 213 were bilateral. PF closure was performed using tacks in 36.7 %, suture in 24.3 %, and staples in 39.0 %. There was no difference in hernia recurrence (only 1 patient at 36 months). There were no statistical differences in QOL between 2 and 4 weeks and 6- to 24-month follow-up. When resolution of symptoms from preoperative levels was examined, there was no difference in the three groups at any time point (p > 0.05). After controlling for confounding variables on multivariate analysis, there was no difference in QOL by PF closure method at any time point (p > 0.05).

Conclusion: Tacked, sutured, and stapled techniques for peritoneal flap closure following TAPP have no significant differences in operative outcomes, postoperative quality of life, or resolution of symptoms.

Citing Articles

QUALITY OF LIFE USING EURAHS-QoL SCORES AFTER SURGICAL TREATMENT OF INGUINAL HERNIA: LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL (TAPP) AND LICHTENSTEIN TECHNIQUES.

Sanderson R, DE-Marchi D, Cesario J, Sanderson L, Zilberstein B Arq Bras Cir Dig. 2024; 37:e1798.

PMID: 38896698 PMC: 11182626. DOI: 10.1590/0102-672020240005e1798.

Glued suture-less peritoneum closure in laparoscopic inguinal hernia repair reduces acute postoperative pain.

Huguenin-Dezot M, Peisl S, Georgiou E, Candinas D, Beldi G, Helbling C Sci Rep. 2024; 14(1):11786.

PMID: 38782992 PMC: 11116422. DOI: 10.1038/s41598-024-62364-w.

Postoperative pain in transabdominal preperitoneal laparoscopic hernia repair with staple fixation versus self-fixation mesh.

Rey Chaves C, Ramirez-Giraldo C, Isaza-Restrepo A, Monroy D, Gonzalez-Tamayo J, Ayala D Heliyon. 2024; 10(9):e30033.

PMID: 38707324 PMC: 11066375. DOI: 10.1016/j.heliyon.2024.e30033.

TITANIUM CLIPS FOR CLOSURE OF THE PERITONEAL FLAP DURING LAPAROSCOPIC INGUINAL HERNIA REPAIR.

Trindade E, Martins E, Trindade M Arq Bras Cir Dig. 2022; 35:e1676.

PMID: 36102486 PMC: 9462858. DOI: 10.1590/0102-672020220002e1676.

CHALLENGES TO THE 10 GOLDEN RULES FOR A SAFE MINIMALLY INVASIVE SURGERY (MIS) INGUINAL HERNIA REPAIR: CAN WE IMPROVE?.

Claus C, Cavazolla L, Furtado M, Malcher F, Felix E Arq Bras Cir Dig. 2021; 34(2):e1597.

PMID: 34669887 PMC: 8521871. DOI: 10.1590/0102-672020210002e1597.

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