Early Outcomes of Laparoscopic Transabdominal Preperitoneal (TAPP) Repair

Abstract

BackgroundInguinal hernia repair is one of the commonest general surgical procedures performed all over the world. The introduction of synthetic mesh and laparoscopic repair has revolutionized inguinal hernia surgery in the recent past. Laparoscopic transabdominal preperitoneal (TAPP) repair is now considered a well-established procedure with minimal complications and short hospital stay and less recurrence. The TAPP approach gives a good view of the inguinal anatomy and a better understanding of the sac contents. The learning curve associated with TAPP repair is much less as compared to total extraperitoneal (TEP) repair. The aim of this study was to assess the effectiveness of TAPP repair for inguinal hernia in terms of the duration of surgery, hospital stay, complications, and recurrence rate. MethodFrom March 1, 2019, to February 28, 2021, a total of 60 patients with inguinal hernias between ages 25 and 70 years were included in the study. A preoperative anesthesia assessment was done, and informed written consent was taken from all patients. The TAPP procedure was performed with polypropylene mesh in all cases, and surgery was performed by a surgeon with more than five years of laparoscopic experience. ResultsThe total number of patients included in the study was 60. All patients were male. The mean±standard deviation (SD) age of the patients was 54.6±11.4 years. Unilateral primary inguinal hernia was present in 46 (76.6%) cases, recurrent in eight (13.3%) cases, and primary bilateral in six (10%) cases. The mean±SD duration of surgery for unilateral inguinal hernia was 59.1±15.7 minutes, and for bilateral hernia, it was 83.5±12.6 minutes. The mean hospital stay was 3.6±1.5 days. Scrotal swelling was noted as a common complication in seven (11.6%) cases, surgical site infection (SSI) in three (5%), mesh infection in two (3.3%), urinary retention in two (3.3%), and chronic pain in one (1.6%). No recurrence was noted. ConclusionTransabdominal preperitoneal repair for inguinal hernia is a very effective procedure with a short learning curve and minimal complication rate. The hospital stay is less, and recurrence is very low.

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

“…The most commonly used methods are the transabdominal preperitoneal (TAPP) and the totally extraperitoneal (TEP) techniques (van den Heuvel and Dwars 2013; Yang and Liu 2016b). TAPP surgery gives a better view of the inguinal anatomy, and the procedure also has a steep learning curve (Ahmad et al 2023). TAPP provides the opportunity for intraoperative detection of asymptomatic contralateral inguinal hernias; thus, a contralateral inguinal hernia can be repaired even in cases of implication (van den Heuvel and Dwars 2013; Mancini et al 2019).…”