Comparison of Laparoscopic TAPP (Transabdominal Preperitoneal) and Laparoscopic TEP (Totally Extra peritoneal) Techniques for Inguinal Hernia Repair- An Observational Study of 60 Cases

Abstract

Introduction: In the last two decades there has been an increased use of laparoscopic inguinal hernia repair compared to open hernia repair. Laparoscopic techniques have been validated as safe and effective in the treatment of groin hernias and have become common where facilities are available. There has been a shift in the last few years from open repair to laparoscopic repair in India. The laparoscopic approach (TEP and TAPP) for inguinal hernia is bound to get more accessible in the near future. Aims and Objectives: The purpose of this study was to compare laparoscopic TAPP (Transabdominal preperitoneal) and laparoscopic TEP (Totally extraperitoneal) repairs for inguinal hernia. Materials and Methodology: This retrospective observational study was conducted in a tertiary care centre from November 2014 to November 2015. It consisted of 60 operated cases of inguinal hernia distributed 30 each in two groups i.e. Group A (TEP) and Group B (TAPP). After taking informed consent, patient details with respect to the study was entered on case record form. Each patient was followed up post-operatively for a period of 3 months. Statistical tests of significance were applied on various intra-operative and post-operative parameters to be compared between the two techniques. Results: The mean duration of surgery by TEP technique was comparatively less than the TAPP technique. The intraoperative bleeding was minimal in cases of those operated by TEP as well as those operated by TAPP. There was no incidence of intraoperative bowel injury in our study in both groups. There was no incidence of intraoperative nerve injury in both groups. There was no difference in intraoperative conversion to open repair rates between TEP and TAPP. Seroma formation in the postoperative period was significant in TEP technique operated patients. There was no evidence of significant cord edema in the early postoperative phase of TEP and TAPP. The postoperative pain was more in TAPP as compared to TEP. There was no incidence of wound infection in TEP and TAPP. There was no difference in duration of hospital stay in TEP and TAPP. There was no difference in cost for surgery between TEP and TAPP. There was no incidence of recurrence of inguinal hernia in TEP as well as TAPP in early post-operative period. There was no difference in patient satisfaction in both the techniques.