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

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.