Laparoscopic Inguinal Hernia Repair: Transabdominal Preperitoneal or Totally Extraperitoneal? Results of a 14-year Prospective Study

Patel, Vikesh; Gupta, Tanya; El-Medani, Faisal; Gupta, Sanjay

doi:10.21614/chirurgia.115.5.600

Cited by 7 publications

(9 citation statements)

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“…24 TEP repair has a long learning curve compared to TAPP hernioplasty procedure. [25][26][27][28] Bleeding occurred intraoperatively twice during very early cases, certainly related to inception with the new procedure, though not severe, not eventful, this never happened once surgeon became familiar with the relatively avascular preperitoneal space and dissecting closer to peritoneum.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we did not encounter bladder or bowel injury, though some publications reported TEP procedures to have higher incidence of serious perioperative complications than open procedures. 26,29,30 Some studies reported that bilateral TEP repair was associated with significantly higher reoperation and urinary bladder injury 27,31 while other studies 24,32 suggested that bilateral repair does not have notably higher risks or mortality than an unilateral repair. 32 Seroma in the inguinal area were encountered in 5 patients and none required intervention.…”

Section: Discussionmentioning

confidence: 99%

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Total extra-peritoneal inguinal hernia repair: experience in a tertiary care hospital of Bangladesh

Ratan

Alam

2023

Birdem Med J

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Background: Open hernioplasty, a traditional procedure, is practiced for decades all over the world, for inguinal hernia repair and the newer procedure of total extraperitoneal (TEP) inguinal hernia repair is the current trend. Aim of this study was to share the experience of TEP inguinal hernia repair. Methods: This retrospective observational study was done from April, 2012 to March, 2021 at BIRDEM General Hospital, Dhaka, Bangladesh. Patients with inguinal hernia reporting to BIRDEM outpatient department (OPD) were counseled for TEP repair. Those who consented were treated electively with a TEP repair for a unilateral or bilateral hernia defect, either direct or indirect. All procedures were completed with patients under general anaesthesia. Polypropylene mesh was placed in preperitoneal space. Followed up records were noted at one week, one month, one and two years after surgery. Patients’ age, hernia types and locations, complications, length of stay in hospital, return to work and recurrence were noted. Results: Total patients were 118 including one female. Patients were between 22 and 72 years. All of them had primary hernias and 72% of them underwent unilateral repairs. One of the cases required conversion to transabdominal preperitoneal procedure. In five patients (4.2%) intraoperative complication occurred and postoperative courses were complicated in 8 patients (6.7%). Patients were able to resume their daily activities after a mean period of 7 days (3 to 10 days). There was no mortality. Conclusion: In patients with uncomplicated inguinal hernias, TEP is associated with a very low overall risk of serious complications and recurrence with a very good functional outcome. It is equally applicable with bilateral inguinal hernias without added risk. BIRDEM Med J 2023; 13(1): 44-48

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Total extra-peritoneal inguinal hernia repair: experience in a tertiary care hospital of Bangladesh

Ratan

Alam

2023

Birdem Med J

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“…The TEP surgery is difficult and should be performed by surgeons skilled in LIHR. TEP is preferred for bilateral hernia ( 27 ). In the treatment of patients with irreducible hernia, recurrent hernia, a long course of disease, or a large hernia sac, TAPP can facilitate the reduction of hernia contents and reveal whether there is intestinal necrosis and other intra-abdominal conditions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Data Analysis for Treatment of Adult Inguinal Hernia by TAPP or TEP

et al. 2022

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BackgroundTransabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair are the primary surgical methods for the treatment of adult inguinal hernia, but it remains necessary to consider which one to choose in clinical practice. Our study seeks to compare the efficacy of laparoscopic TAPP and laparoscopic TEP in the treatment of adult inguinal hernia and to explore which surgical method is a better choice.MethodsA retrospective analysis of 686 adult patients with inguinal hernia admitted to our hospital from the period January 2016 to December 2020 was conducted. According to different surgical methods, they were divided into two groups: a TAPP group (n = 361) and a TEP group (n = 325). These two groups of patients were statistically analyzed, and the operation time, postoperative pain, postoperative hospital stay length, postoperative complications, and recurrence rate were compared between them.ResultsThere were no significant differences in postoperative hospital stay, complications, and the recurrence rate between the two groups (p > 0.05). The duration of operation in the TEP group was significantly shorter than that in the TAPP group, and the difference was statistically significant (p < 0.001); in terms of postoperative pain, the TEP group fared better than the TAPP group, and the difference was statistically significant (p < 0.001).ConclusionTAPP and TEP are safe and effective surgical methods in the treatment of adult inguinal hernia. However, compared with TAPP, TEP can significantly shorten the operative time, reduce intraoperative trauma, and limit postoperative pain in the treatment of adult inguinal hernia. Furthermore, it does not increase the rate of complications or recurrence, so it is worth popularizing.

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“…The intraperitoneal area is not entered unlike the TAPP technique. The disadvantage of TEP is the steep learning curve, and the results vary according to surgical experience 4–6. Because of these advantages, TEP repair has become one of the most popular approaches worldwide with good short-term and long-term outcomes 7…”

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confidence: 99%

“…The disadvantage of TEP is the steep learning curve, and the results vary according to surgical experience. [4][5][6] Because of these advantages, TEP repair has become one of the most popular approaches worldwide with good short-term and long-term outcomes. 7 Conversion is defined as the transition to another surgical method because of technical inadequacy or anatomical limitations of the planned surgical method.…”

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confidence: 99%

Risk Factors for Conversion in Laparoscopic Totally Extraperitoneal Inguinal Hernioplasty

Karabulut

Dönmez

Şahbaz

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Conversion is a surgical concern because the surgical technique can change during surgery. Surprisingly, there is no study in the literature on the causes and risk factors leading to conversion in laparoscopic total extraperitoneal inguinal repair (TEP). There is also no consensus on the prevention and causes of this condition in TEP. The aim of this study was to evaluate the risk factors underlying the development of conversion during TEP. Materials and Methods: We recruited 962 consecutive patients who underwent TEP between May 2016 and May 2021. All data were collected retrospectively. The outcomes of patients who converted to open surgery were compared with those without conversion. Multivariate analysis identified independent risk factors for conversion. Results: The overall incidence of conversion was 4.05% (n=39). The median age was 42 years (18 to 83) and body mass index was 25.2 kg/m2 (15.67 to 32.9). Significant clinical factors associated with conversion included old age, American Society of Anesthesiologists (ASA) score, large peritoneal tear (PT), Charlson comorbidity index, previous surgery, large hernial defects, presence of scrotal hernia, and the defect size of inguinal hernia. Multivariate analysis identified independent risk factors for conversion: large hernial defect, large PT, previous lower abdominal surgery, previous hernia surgery, and scrotal hernia. Conclusion: Conversion is a minor complication seen during TEP and its incidence varies depending on many factors. Previous lower abdominal surgery and a large PT carries a 6-fold increased risk for conversion from laparoscopic to open surgery during TEP.

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Laparoscopic Inguinal Hernia Repair: Transabdominal Preperitoneal or Totally Extraperitoneal? Results of a 14-year Prospective Study

Cited by 7 publications

References 0 publications

Total extra-peritoneal inguinal hernia repair: experience in a tertiary care hospital of Bangladesh

Total extra-peritoneal inguinal hernia repair: experience in a tertiary care hospital of Bangladesh

Clinical Data Analysis for Treatment of Adult Inguinal Hernia by TAPP or TEP

Risk Factors for Conversion in Laparoscopic Totally Extraperitoneal Inguinal Hernioplasty

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