Totally Extra-peritoneal Repair Versus Trans-abdominal Pre-peritoneal Repair for the Laparoscopic Surgical Management of Sportsman's Hernia: A Systematic Review and Meta-analysis

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2021 May 19

PMID 34008111

Citations 3

Authors

Aaron Kler

Nisa Sekhon

George A Antoniou

Thomas Satyadas

Affiliations

Soon will be listed here.

Abstract

Background: Open and laparoscopic modalities are employed for treatment of sportsman's hernia with totally extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) laparoscopic approaches both currently being utilised. At present, neither subtype has demonstrated a beneficial superiority for sportsman's hernia repair, as concluded in the most recent systematic review comparing the outcomes of each technique. The aim of this review was to evaluate current evidence to ascertain whether there was a difference in laparoscopic techniques following sportsman's hernia repair.

Methods: A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. Databases searched included PubMed, Scopus and Web of Science to identify all randomised controlled trials (RCTs) and observational studies Risk of bias was assessed using the Cochrane risk of bias tool and Newcastle-Ottawa scale for RCTs and observational studies, respectively.The assessed outcomes included median time to return to sporting activity, complications and the degree of postoperative pain reduction within three months. Random effects model was used to calculate pooled proportion data where feasible. Subgroup analyses were also performed.

Results: 28 studies were identified including 2 RCTs and 26 observational studies. No significant differences were observed between techniques in the primary or secondary outcomes. Significant heterogeneity was observed in all outcomes. This was more pronounced for return to sporting activity meaning that meta-analysis was not feasible in this domain. Median time to return to sporting activity was 28 days for both techniques.

Conclusions: There is no observed difference in the primary and secondary outcomes in either technique. An RCT comparing TEP and TAPP repair is needed to provide definitive data on this matter.

Citing Articles

Sportsman's Hernia repair using Nesovic procedure, a 13-year single-center experience.

Vicenty T, Serenon V, Aubert M, Omouri A, Le Huu Nho R, Pirro N Updates Surg. 2024; 77(1):231-236.

PMID: 39636349 DOI: 10.1007/s13304-024-02047-3.

TEP or TAPP: who, when, and how?.

Iossa A, Traumueller Tamagnini G, De Angelis F, Micalizzi A, Lelli G, Cavallaro G Front Surg. 2024; 11:1352196.

PMID: 39077677 PMC: 11284065. DOI: 10.3389/fsurg.2024.1352196.

Lichtenstein versus TIPP versus TAPP versus TEP for primary inguinal hernia, a matched propensity score study on the French Club Hernie Registry.

Hurel R, Bouazzi L, Barbe C, Kianmanesh R, Romain B, Gillion J Hernia. 2023; 27(5):1165-1177.

PMID: 36753035 DOI: 10.1007/s10029-023-02737-8.

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