Laparoscopic inguinal hernia repair: transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) approach: a prospective randomized controlled trial
- 30 September 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 26 (3), 639-649
- https://doi.org/10.1007/s00464-011-1931-7
Abstract
Minimal access approaches to inguinal hernia repair have added to the ongoing debate over the “best groin hernia repair.” The present prospective randomized controlled trial was done to compare the totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) techniques of laparoscopic inguinal hernia repair. The present prospective randomized study was conducted between May 2007 and March, 2009 and included 100 patients suffering from uncomplicated primary groin hernia. Patients were randomized into group I (TEP) and group II (TAPP). Intraoperative variables and postoperative pain scores were recorded in a prestructured form. One hundred patients were included in the study (TEP, 53; TAPP, 47). Both groups were comparable in terms of demographic profile and hernia characteristics. The average operative time was higher in the TAPP group (p = 0.209). The pain scores at 1 h and 24 h after surgery and at 3-month follow-up were significantly higher in the TAPP group (p < 0.05). The average follow-up was 30.5 months. In the TEP group, 37.8% of patients had seroma compared to 18.3% in the TAPP group (p = 0.021). However, there was a higher incidence of scrotal edema in the TAPP group (16 vs. 9, p = 0.009). The wound infection rates were equal (2% vs. 3%). There has been no recurrence in either group during the follow-up period of 44 months. Overall, the patients were more satisfied with TEP rather than TAPP (p < 0.05). In the present study, TEP had a significant advantage over TAPP for significantly reduced postoperative pain up to 3 months, which resulted in a better patient satisfaction score. The other intraoperative complications, postoperative complications, and cost were similar in both groups. In terms of results, both repair techniques seemed equally effective, but TEP had an edge over TAPP.Keywords
This publication has 37 references indexed in Scilit:
- Total extraperitoneal (TEP) mesh repair of inguinal hernia in the developing world: comparison of low-cost indigenous balloon dissection versus direct telescopic dissection: a prospective randomized controlled studySurgical Endoscopy, 2008
- Total extra-peritoneal repair of groin hernia: prospective evaluation at a tertiary care centerHernia, 2007
- Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair.Emergencias, 2005
- Open Mesh versus Laparoscopic Mesh Repair of Inguinal HerniaThe New England Journal of Medicine, 2004
- Seroma following endoscopic extraperitoneal inguinal hernioplastySurgical Endoscopy, 2003
- Chronic pain and quality of life following open inguinal hernia repairBritish Journal of Surgery, 2001
- Is a dissection balloon beneficial in totally extraperitoneal endoscopic hernioplasty (TEP)?Surgical Endoscopy, 2001
- Endoskopische Operationstechniken - Erfahrungen und Besonderheiten - LeistenhernieViszeralchirurgie, 2000
- Endoscopic totally extraperitoneal repair of bilateral inguinal herniasBritish Journal of Surgery, 1999
- A Comparative Study of Laparoscopic Extraperitoneal and Transabdominal Preperitoneal HerniorrhaphyJournal of Laparoendoscopic Surgery, 1995