Comparative analysis of comorbidity, surgical complications, pharmacotherapeutic needs, and rehabilitation requirements in transabdominal preperitoneal hernia repair versus conventional operative treatment—current results and benefits

Abstract

Background: Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is a relatively new method of inguinal hernia surgical repair that, at theory, provides a good view of the inguinal anatomy and sac contents and, as a laparoscopic procedure, is considered less invasive and with fewer complications compared to total extraperitoneal (TEP) inguinal hernia repair. Purpose: This study aims to assess the short-term outcome of laparoscopic transabdominal preperitoneal inguinal hernia (TAPP) repair. Material and methods: The retrospective clinical data for 138 patients with unilateral and bilateral hernia, operated in the Department of General, Visceral, and Emergency Surgery of the University Emergency Medicine Hospital ‘N. Pirogov’ from 01 January 2022, to 01 January 2023, were included. The risk profile of the patients, the intraoperative and postoperative complications, the duration of hospital stay, the frequency, and the type of analgesics used were analyzed. Results: Forty-one women (29.7%) were included; men comprised 97 (70.29%) of the cohort. Of the selected group, 63 (45.7%) patients had indirect inguinal hernias, 34 (24.6%), and 25 (18.1%) were diagnosed with direct inguinal hernia and accreta inguinal hernia, respectively. A history of repeatedly occurring hernias was found in 16 patients (11.6%). The average hospital stay was 32 hours (or 1.3 days) and ranged from 24 hours (1 day) to 48 hours (2 days). Complications occurred in 11 (7.97%) patients. The need for analgesics and anti-inflammatory agents was reliably reduced compared to the patients undergoing conventional surgical treatment of inguinal hernia. The patients were followed for three months post-discharge for the occurrence of surgical morbidity associated with the TAPP hernia repair. None of the patients used an antimicrobial agent, as indicated by a possible complicating bacterial infection. Rehabilitation was started within the first 12 hours after the operation, thus contributing to a significantly shorter hospital stay compared to patients undergoing conventional surgical repair of an inguinal hernia. Conclusion: Our results demonstrate that TAPP inguinal hernia repair is a safe procedure with reduced postoperative pain. It has fewer complications, with no significantly longer operative time and a shorter overall hospital stay.