Comparison of Perioperative Complication Rates of Total Extraperitoneal and Transabdominal Preperitoneal Repairs in Primary Inguinal Hernia

Overview

Journal J West Afr Coll Surg

Specialty General Medicine

Date 2024 Mar 15

PMID 38486649

Authors

Manoj Kumar Dokania

Ankur Ankur

Nitin Agarwal

Atul Jain

Anshu Anshu

Rana A K Singh

Affiliations

Soon will be listed here.

Abstract

Background: Hernia may be defined as a protrusion of viscus through layers anatomically designed to contain that viscus. Most abdominal hernias occur at well-described sites of potential weakness. Repair of inguinal hernia is one of the most common operations in general surgery. Objectives: To compare the perioperative complication rates of total extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) repairs of primary inguinal hernias.

Materials And Methods: It is a randomised comparative study, conducted at the department of general surgery. A total of 50 patients were included and divided into two groups with 25 in each. Group A represents the laparoscopic TEP repair and group B represents the laparoscopic TAPP repair. Patients above 18 years with primary unilateral inguinal hernia were included. Patients having complicated inguinal hernia and history of previous abdominal surgery were excluded.

Results: We observed that hernia occurrence is more common in the 31-50 years of age group and right-sided hernia is more common. Scrotal oedema and conversion to open surgery chances are similar in both TEP and TAPP groups. The duration of surgery in TEP is significantly higher as compared to TAPP. Patients who underwent TEP experienced less pain as compared to TAPP as per visual analogue scale. Postoperative hospital stay and time taken to resume the routine activity were significantly less in case of TEP.

Conclusion: TEP is preferred over TAPP for laparoscopic hernia repair because it preserves the peritoneal integrity and has lesser postoperative pain. The early recovery and return to the routine work were seen with the patient treated with the TEP and also showed better visual analogue score than the TAPP repair group.

References

Jenkins J, ODwyer P . Inguinal hernias. BMJ. 2008; 336(7638):269-72. PMC: 2223000. DOI: 10.1136/bmj.39450.428275.AD. View

Gass M, Banz V, Rosella L, Adamina M, Candinas D, Guller 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. DOI: 10.1007/s00268-012-1760-4. View

Schrenk P, Woisetschlager R, Rieger R, Wayand W . Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or Shouldice technique for inguinal hernia repair. Br J Surg. 1996; 83(11):1563-6. DOI: 10.1002/bjs.1800831124. View

Bittner R, Montgomery M, Arregui E, Bansal V, Bingener J, Bisgaard T . Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2014; 29(2):289-321. PMC: 4293469. DOI: 10.1007/s00464-014-3917-8. View

Bittner R, Arregui M, Bisgaard T, Dudai M, Ferzli G, Fitzgibbons R . Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc. 2011; 25(9):2773-843. PMC: 3160575. DOI: 10.1007/s00464-011-1799-6. View

Kamat M, Singh N, Nattey K . A rare encounter of obstructed direct inguinal hernia of sliding variety. Int J Surg Case Rep. 2018; 49:209-214. PMC: 6076353. DOI: 10.1016/j.ijscr.2018.06.025. View

McCormack K, Wake B, Fraser C, Vale L, Perez J, Grant A . Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review. Hernia. 2005; 9(2):109-14. DOI: 10.1007/s10029-004-0309-3. View

Chung L, Norrie J, ODwyer P . Long-term follow-up of patients with a painless inguinal hernia from a randomized clinical trial. Br J Surg. 2011; 98(4):596-9. DOI: 10.1002/bjs.7355. View

Oberg S, Andresen K, Rosenberg J . Etiology of Inguinal Hernias: A Comprehensive Review. Front Surg. 2017; 4:52. PMC: 5614933. DOI: 10.3389/fsurg.2017.00052. View

10.

Shakya V, Sood S, Bhattarai B, Agrawal C, Adhikary S . Laparoscopic inguinal hernia repair: a prospective evaluation at Eastern Nepal. Pan Afr Med J. 2014; 17:241. PMC: 4145269. DOI: 10.11604/pamj.2014.17.241.2610. View

11.

Sharma D, Yadav K, Hazrah P, Borgharia S, Lal R, Thomas S . Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias. Int J Surg. 2015; 22:110-7. DOI: 10.1016/j.ijsu.2015.07.713. View

12.

Chen L, Chen W, Kang Y, Wu C, Tsai L, Liu M . Effects of transabdominal preperitoneal and totally extraperitoneal inguinal hernia repair: an update systematic review and meta-analysis of randomized controlled trials. Surg Endosc. 2018; 33(2):418-428. DOI: 10.1007/s00464-018-6314-x. View

13.

Primatesta P, Goldacre M . Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996; 25(4):835-9. DOI: 10.1093/ije/25.4.835. View

14.

Rutkow I . Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am. 2003; 83(5):1045-51, v-vi. DOI: 10.1016/S0039-6109(03)00132-4. View

15.

ODwyer P, Norrie J, Alani A, Walker A, Duffy F, Horgan P . Observation or operation for patients with an asymptomatic inguinal hernia: a randomized clinical trial. Ann Surg. 2006; 244(2):167-73. PMC: 1602168. DOI: 10.1097/01.sla.0000217637.69699.ef. View

16.

Nordback I . Side incidence of inguinal hernias. Ann Chir Gynaecol. 1984; 73(2):87-90. View

17.

Bansal V, Krishna A, Misra M, Kumar S . Learning Curve in Laparoscopic Inguinal Hernia Repair: Experience at a Tertiary Care Centre. Indian J Surg. 2016; 78(3):197-202. PMC: 4907907. DOI: 10.1007/s12262-015-1341-5. View

18.

Burcharth J, Pedersen M, Bisgaard T, Pedersen C, Rosenberg J . Nationwide prevalence of groin hernia repair. PLoS One. 2013; 8(1):e54367. PMC: 3544713. DOI: 10.1371/journal.pone.0054367. View

19.

Singh A, Bansal V, Misra M, Kumar S, Rajeshwari S, Kumar A . Testicular functions, chronic groin pain, and quality of life after laparoscopic and open mesh repair of inguinal hernia: a prospective randomized controlled trial. Surg Endosc. 2011; 26(5):1304-17. DOI: 10.1007/s00464-011-2029-y. View

20.

Swanstrom L . Laparoscopic herniorrhaphy. Surg Clin North Am. 1996; 76(3):483-91. DOI: 10.1016/s0039-6109(05)70455-2. View