COMPARISON OF TOTAL EXTRAPERITONEAL (TEP) AND EXPANDED VIEW TOTAL EXTRAPERITONEAL (eTEP) METHODS AT INGUINAL HERNIA REPAIR

Abstract

Abstract Background Laparoscopic hernia repair has been accepted as first-line treatment for inguinal hernia by major surgical institutions today, with low complication and recurrence rates. The aim of this prospective clinical study, we compared two different laparoscopic approaches in terms of technical ease, patients' early postoperative quality of life, pain management, complication and early recurrence rates. Method Patients with inguinal hernia who were planned to undergo laparoscopic hernia repair were randomized and operated with total extraperitoneal repair (TEP) and extended view total extraperitoneal repair (eTEP) methods in July and August 2023. During the postoperative follow-up, 24th-hour pain scores and 24th-hour quality of life scores were noted with a visual analogue scale (VAS) and quality of recovery test (QoR T15). At the 1st week outpatient clinic follow-up, their pain scores were questioned with VAS. They were checked by physical examination for complications or early recurrence. Patients were called for follow-up at the 1st and 3rd months after the surgery. Results The number of fixative staples was significantly higher in TEP group (p < 0.001). The operation time was significantly shorter in eTEP group (p: 0.031). Time to return to work was significantly longer in TEP group (p: 0.024). VAS scores on the 1st postoperative day were found to be significantly lower in eTEP group (p < 0.001), no significant difference was detected in the 1st week scores. The QoR test scores on the first postoperative day were significantly higher in eTEP group (p:0.006). The difference between number of patients with seroma, ecchymosis or hematoma was not significant in two groups. Conclusions Both methods we used did not make a significant difference in the incidence of complications. On the other hand, we revealed that eTEP method may be more advantageous in terms of ease of surgery, patients' quality of life in the early period.