Randomized Comparative Study Between Laparoscopic Transabdominal Pre-Peritoneal Versus Totally Extraperitoneal Approach in Inguinal Hernia Repair
Advances in Surgical Sciences
Volume 6, Issue 1, June 2018, Pages: 1-6
Received: Jan. 13, 2018; Accepted: Jan. 26, 2018; Published: Feb. 19, 2018
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Authors
Abdelaziz Osman Elhendawy, Gastrointestinal and Laparoscopic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Osama Hasan Abd-Raboh, Gastrointestinal and Laparoscopic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Taha Ahmad Ismail, Gastrointestinal and Laparoscopic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Abdelmonem Ahmad Nagy, Gastrointestinal and Laparoscopic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Abstract
Background: Whether totally extraperitoneal inguinal hernia repair (TEP) is associated with better outcomes than transabdominal preperitoneal inguinal hernia repair (TAPP) continues to be a matter of debate. The objective of this study is to compare outcomes between patients undergoing TEP or TAPP. Methods: This prospective randomized comparative study was carried out in Gastrointestinal and Laparoscopic Surgery Unit, General Surgery Department, Tanta University Hospitals from May 2016 to May 2017, on 30 patients with inguinal hernia, divided into 2 equal groups: Group I: subjected to Transabdominal Pre-peritoneal (TAPP) inguinal hernia repair (15 cases). Group II: subjected to Totally Extraperitoneal (TEP) inguinal hernia repair (15 cases). Results: The mean age was 47.8±10.4 ranged from 19-65 years. All patients were presented with indirect inguinal hernia. All cases were male except one female patient. Operative time was 151.7±24.8 in TAPP approach in comparison to 88.42±30.6 minutes in TEP approach. Post-operative scrotal edema was higher in TAPP approach (9 cases) in comparison to TEP approach (3cases). Postoperative Hematoma and ileus were higher in TAPP technique (2cases). Postoperative Surgical emphysema was higher in TEP technique (3cases). Hospital stay in TAPP approach was longer than TEP approach. There was no difference regarding wound infection, mesh infection and recurrence. Follow up for 6 months of all cases for complication. Conclusion: TEP approach as the laparoscopic procedure of choice for inguinal hernia repair due to short operative time and less hospital stay than TAPP approach.
Keywords
Inguinal Hernia, TEP, Totally Extraperitoneal, TAPP, Transabdominal Preperitoneal, Mesh, Fixation, Tacker
To cite this article
Abdelaziz Osman Elhendawy, Osama Hasan Abd-Raboh, Taha Ahmad Ismail, Abdelmonem Ahmad Nagy, Randomized Comparative Study Between Laparoscopic Transabdominal Pre-Peritoneal Versus Totally Extraperitoneal Approach in Inguinal Hernia Repair, Advances in Surgical Sciences. Vol. 6, No. 1, 2018, pp. 1-6. doi: 10.11648/j.ass.20180601.11
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Primatesta P., Goldacre M. J. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996; 25 (4):835-839.
[2]
Krishna A., Misra M. C., Bansal V. K., Kumar S., Rajeshwari S., Chabra A. Laparoscopic inguinal hernia repair: transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) approach: a prospective randomized controlled trial. Surgical endoscopy. 2012; 26 (3):639-649.
[3]
McCormack K, Wake BL, Fraser C, Vale L, Perez J, Grant A. Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review. Hernia: the journal of hernias and abdominal wall surgery. 2005; 9 (2):109-114.
[4]
Bittner R. [Evidence-based TAPP technique]. Chirurg. 2017; 88 (4):281-287.
[5]
Wake B. L., McCormack K., Fraser C., Vale L., Perez J., Grant A. M. Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. The Cochrane database of systematic reviews. 2005 (1):Cd004703.
[6]
O'Reilly E. A., Burke J. P., O'Connell P. R. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Annals of surgery. 2012; 255 (5):846-853.
[7]
Schein Moshe. Schwartz’s Principles of Surgery, F. Charles Brunicardi, Dana K. Andersen, Timothy R. Billiar, David L. Dunn, John G. Hunter, Jeffrey B. Matthews, Raphael E. Pollock World Journal of Surgery. 2010; 34 (4):871-873.
[8]
Sharma A., Chelawat P. Endo-laparoscopic inguinal hernia repair: What is its role? Asian journal of endoscopic surgery. 2017; 10 (2):111-118.
[9]
Jenkins J. T., O'Dwyer P. J. Inguinal hernias. Bmj. 2008; 336 (7638):269-272.
[10]
2017 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Houston, Texas, USA, 22-25 March 2017: Poster Presentations. Surgical endoscopy. 2017; 31 (Suppl 1):137-334.
[11]
Bansal V. K., Misra M. C., Babu D., Victor J., Kumar S., Sagar R., Rajeshwari S., Krishna A., Rewari V. A prospective, randomized comparison of long-term outcomes: chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surgical endoscopy. 2013;27.
[12]
Köckerling F., Bittner R., Jacob D. A., Seidelmann L., Keller T., Adolf D., Kraft B., Kuthe A. TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surgical endoscopy. 2015; 29 (12):3750-3760.
[13]
Kumar Praveen, Kumar Nilkamal. Trans abdominal pre-peritoneal versus totally extra-peritoneal laparoscopic techniques for inguinal hernia repair: a comparative study. 2016. 2016; 4 (1):4.
[14]
Khan Muhammad Siddique, Zeb Junaid, Zaman Amer. Conversion of laparoscopic total extraperitoneal inguinal hernia (TEP) repair to transabdominal preperitoneal (TAPP) repair. Rawal Medical Journal. 2017; 42 (2).
[15]
Bracale U., Melillo P., Pignata G., Di Salvo E., Rovani M., Merola G., Pecchia L. Which is the best laparoscopic approach for inguinal hernia repair: TEP or TAPP? A systematic review of the literature with a network meta-analysis. Surgical endoscopy. 2012; 26 (12):3355-3366.
[16]
Lau H., Patil N. G., Yuen W. K., Lee F. Management of peritoneal tear during endoscopic extraperitoneal inguinal hernioplasty. Surgical endoscopy. 2002; 16 (10):1474-1477.
[17]
GANDHI CHINMAY, DHONDE ASHOK, MOTE DAJIRAM. Pilot study of selective fixation of mesh in laparoscopic extra-peritoneal inguinal hernia repair (TEP). International J of Healthcare and Biomedical Research. 2017; 5 (04):77-84.
[18]
Hamza Y., Gabr E., Hammadi H., Khalil R. Four-arm randomized trial comparing laparoscopic and open hernia repairs. Int J Surg. 2010;8.
[19]
Dedemadi G., Sgourakis G., Karaliotas C., Christofides T., Kouraklis G., Karaliotas C. Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias: a prospective randomized study. Surgical Endoscopy And Other Interventional Techniques. 2006; 20 (7):1099-1104.
[20]
Günal Ö., Özer Ş., Gürleyik E., Bahçebaşı T. Does the approach to the groin make a difference in hernia repair? Hernia: the journal of hernias and abdominal wall surgery. 2007; 11 (5):429-434.
[21]
More Dr. Milind P., Nasta Dr. Amrit Manik, More Dr. Rakhi M., Shedg Dr. Rakesh. Comparison of Laparoscopic TAPP (Transabdominal Preperitoneal) and Laparoscopic TEP (Totally Extra peritoneal) Techniques for Inguinal Hernia Repair- An Observational Study of 60 Cases. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2016; 15 (7):90-93.
[22]
Bansal V. K., Misra M. C., Babu D., Victor J., Kumar S., Sagar R., Rajeshwari S., Krishna A., Rewari V. A prospective, randomized comparison of long-term outcomes: chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surgical endoscopy. 2013; 27 (7):2373-2382.
[23]
Verma Nimesh, Prajapati Keyur, Mistry Siddharth, Bagmar Gaurav, Kumar Ajay, Patel Dharmik. A comparative study between total extraperitoneal (TEP) repair and Transabdominal pre-peritoneal (TAPP) repair in management of inguinal hernia. National Journal Of Medical Research. 2015;5:64-66.
[24]
Gong K., Zhang N., Lu Y., Zhu B., Zhang Z., Du D., Zhao X., Jiang H. Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surgical endoscopy. 2011; 25 (1):234-239.
[25]
Pokorny H., Klingler A., Schmid T., Fortelny R., Hollinsky C., Kawji R., Steiner E., Pernthaler H., Függer R., Scheyer M. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia: the journal of hernias and abdominal wall surgery. 2008;12.
[26]
He Zirui, Hao Xiaohui, Li Jianwen, Zhang Yun, Feng Bo, Yue Fei, Xue Pei, Gong Hangjun. Laparoscopic inguinal hernia repair in elderly patients: single center experience in 12 years. Annals of Laparoscopic and Endoscopic Surgery. 2017; 2 (1).
[27]
Neumayer L., Giobbie-Hurder A., Jonasson O., Fitzgibbons R., Jr., Dunlop D., Gibbs J., Reda D., Henderson W. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004; 350 (18):1819-1827.
[28]
Lau H., Patil N. G., Yuen W. K., Lee F. Prevalence and severity of chronic groin pain after endoscopic totally extraperitoneal inguinal hernioplasty. Surgical endoscopy. 2003; 17 (10):1620-1623.
[29]
Haidenberg Jaime, Kendrick Michael L., Meile Tobias, Farley David R. Totally extraperitoneal (TEP) approach for inguinal hernia: the favorable learning curve for trainees. Current Surgery. 2003; 60 (1):65-68.
[30]
Wake Beverly L, McCormack Kirsty, Fraser Cynthia, Vale Luke, Perez Juan, Grant Adrian. Transabdominal pre‐peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. The Cochrane Library. 2005.
[31]
Schmedt C-G, Däubler P, Leibl BJ, Kraft K, Bittner R. Simultaneous bilateral laparoscopic inguinal hernia repair. Surgical endoscopy. 2002; 16 (2):240-244.
[32]
Kapiris SA, Brough WA, Royston CMS, O’Boyle C, Sedman PC. Laparoscopic transabdominal preperitoneal (TAPP) hernia repair. Surgical endoscopy. 2001; 15 (9):972-975.
[33]
Leibl Bernhard J, Schmedt Claus-Georg, Schwarz Jochen, Däubler Peter, Kraft Klaus, Schloßnickel Barbara, Bittner Reinhard. A single institution’s experience with transperitoneal laparoscopic hernia repair. The American journal of surgery. 1998; 175 (6):446-452.
[34]
Bittner R, Schmedt C‐G, Schwarz J, Kraft K, Leibl BJ. Laparoscopic transperitoneal procedure for routine repair of groin hernia. British journal of surgery. 2002; 89 (8):1062-1066.
[35]
Misra Mahesh C., Kumar Sareesh, Bansal Virinder K. 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 study. Surgical endoscopy. 2008; 22 (9):1947.
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