TEP or TAPP for recurrent inguinal hernia repair—register-based comparison of the outcome

Köckerling, F.; Bittner, R.; Kuthe, A.; Hukauf, Martin; Mayer, F; Fortelny, René H.; Schug-Paß, C.

doi:10.1007/s00464-017-5416-1

Cited by 34 publications

(22 citation statements)

References 22 publications

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“…Meta‐analysis showed no significant difference in hernia recurrence between laparoscopic and open repairs. These results are in keeping with the non‐significant differences reported in a previous meta‐analysis and large cohort studies. Thirty‐eight of the 46 studies that examined this outcome used clinical examination for diagnosing recurrence; the rest reported the use of a questionnaire or telephone interview.…”

Section: Discussionsupporting

confidence: 86%

Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair

Patterson

Beck

Currie

et al. 2019

British Journal of Surgery

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Background: Inguinal hernia repair is a common low-risk intervention. Patient-reported outcomes (PROs) are being used increasingly as primary outcomes in clinical trials. The aim of this study was to review and meta-analyse the PROs in RCTs comparing laparoscopic versus open inguinal hernia repair techniques in adult patients.Methods: A systematic review and meta-analysis was carried out in accordance with PRISMA guidelines. Only RCTs in peer-reviewed journals were considered. PubMed, Ovid Embase, Scopus and the Cochrane Library were searched. In addition, four trial registries were searched. The search interval was between 1 January 1998 and 1 May 2018. Identified publications were reviewed independently by two authors. The review was registered in the PROSPERO database (CRD42018099552). Bias was assessed using the Cochrane Collaboration risk-of-bias tool.Results: Some 7192 records were identified, from which 58 unique RCTs were selected. Laparoscopic hernia repair was associated with significantly less postoperative pain in three intervals: from 2 weeks to within 6 months after surgery (risk ratio (RR) 0⋅74, 95 per cent c.i. 0⋅62 to 0⋅88), 6 months to 1 year (RR 0⋅74, 0⋅59 to 0⋅93) and 1 year onwards (RR 0⋅62, 0⋅47 to 0⋅82). Paraesthesia (RR 0⋅27, 0⋅18 to 0⋅40) and patient-reported satisfaction (RR 0⋅91, 0⋅85 to 0⋅98) were also significantly better in the laparoscopic repair group. Conclusion:The data and analysis reported in this study reflect the most up-to-date evidence available for the surgeon to counsel patients. It was constrained by heterogeneity of reporting for several outcomes. Summary measures and synthesis of resultsPROs are shown as crude rates and, if appropriate, mean scores. Meta-analysisMeta-analysis was undertaken for each distinct outcome if there were two or more RCTs that examined the same

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Section: Discussionsupporting

confidence: 86%

Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair

Patterson

Beck

Currie

et al. 2019

British Journal of Surgery

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“…In the largest [46] of five meta-analyses [46][47][48][49][50] comparing laparo-endoscopic versus open repair of recurrent hernias following previous open non-mesh and mesh procedures, the minimally invasive technique was associated with less wound complications and a faster recovery to normal activity, whereas the re-recurrence rate was comparable between these two methods. In a registrybased study comparing TEP and TAPP for recurrent inguinal hernia repair, the results concerning intraoperative complications, complication-related reoperations, re-recurrences, pain at rest, pain on exertion, or chronic pain requiring treatment were equivalent [51]. Accordingly, all guidelines [1,[5][6][7][8][9] recommend recurrent inguinal hernia repair following previous open surgery in the TEP or TAPP technique, since the operation is performed in an anatomic layer between the peritoneum and the abdominal wall in which no previous dissection has been performed [1,[5][6][7][8][9]28].…”

Section: Recurrent Inguinal Herniamentioning

confidence: 99%

Current Concepts of Inguinal Hernia Repair

2018

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With more than 20 million patients annually, inguinal hernia repair is one of the most often performed surgical procedures worldwide. The lifetime risk to develop an inguinal hernia is 27-43% for men and 3-6% for women. In spite of all advances, 11% of all patients suffer from a recurrence and 10-12% from chronic pain following primary inguinal hernia repair. By developing evidence-based guidelines and recommendations, the international hernia societies aim to improve the outcome of inguinal hernia repair due to standardization of care. From a total of more than 100 different repair techniques for inguinal and femoral hernias, classified as tissue repair, open mesh repair, and laparo-endoscopic mesh repair, the new International Guidelines of the Hernia-Surge Group only recommend the totally extraperitoneal patch plasty (TEP), transabdominal preperitoneal patch plasty (TAPP), and Lichtenstein techniques. Since a generally accepted technique suitable for all inguinal hernias does not exist, surgeons should provide both an anterior open (Lichtenstein) and a posterior laparo-endoscopic (TEP or TAPP) approach option. The guidelines strongly recommend that surgeons tailor the treatment of inguinal hernias based on expertise, local/national resources, and patient- and hernia-related factors. A tailored approach in inguinal hernia repair should pay heed to the patient- and hernia-related factors, unilateral hernia in men and women, bilateral hernia, recurrent hernia, scrotal hernia, previous pelvic and lower abdominal surgery, severe cardiac or pulmonary comorbidities, and incarcerated hernia.

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“…One population‐based study confirmed higher postoperative complications with the laparoscopic TAPP approach than the TEP approach . Another large‐scale registry study also revealed a higher seroma formation rate using the laparoscopic TAPP approach than the TEP approach when repairing recurrent groin hernias . Therefore, on the basis of the above evidence, we proposed that robot‐assisted TEP repair could in fact be a better approach than TAPP despite the lack of previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…In the robotic era, most of the reported robot‐assisted techniques were performed using the TAPP approach, except in very limited case reports of simultaneous TEP repair during a robot‐assisted radical prostatectomy . Although these two standardized laparoscopic approaches for groin hernia repair are comparable in their long‐term clinical outcomes, the TAPP approach was associated with more surgical complications and seroma formation than was the TEP approach in a large‐scale population‐based study …”

Section: Introductionmentioning

confidence: 99%

Novel robot‐assisted laparoscopic total extra‐peritoneal repair with primary fascial closure plus pre‐peritonea mesh for large groin defects

Chen

et al. 2019

Robotics Computer Surgery

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Background:Since the introduction of robot-assisted laparoscopic surgery, a variety of conventional laparoscopic procedures have been explored via this approach. In the robotic era, most of the reported robot-assisted laparoscopic hernia repairs were performed with the trans-abdominal pre-peritoneal approach.According to the evidence extrapolated from laparoscopic ventral hernia repair, simultaneous fascial defect closure and mesh repair can significantly decrease the risk of seroma formation and recurrence over those without fascial closure.Therefore, we describe our novel technique of robot-assisted total extraperitoneal (TEP) repair with primary fascial closure and pre-peritoneal mesh and its preliminary clinical outcomes. Methods: We retrospectively reviewed our prospectively collected hernia database from October 2017 to July 2019, which included 26 consecutive patients with primary or recurrent groin hernias. Patients' baseline characteristics and perioperative outcomes were compared and analyzed. Perioperative factors included operative time, visual analog scale (VAS) score (0-100), hospital stay, perioperative complications, time to return to normal activity, and the modified Medical Outcome Study (MOS; item 3-12/36 items) score. Results: All procedures were completed successfully without conversion to open or conventional laparoscopic surgery. The patients' age ranged from 28 to 74 years (median 57.5). The mean operative time was 115 minutes (range 95-172 min). There were no major procedure-related complications. Only four cases experienced asymptomatic seromas, which were detected by ultrasonography; and all resolved spontaneously within 6 weeks after the operation. The VAS and modified MOSs revealed quick recovery after robot-assisted endoscopic TEP repair.Conclusions: Robot-assisted endoscopic TEP repair combined with primary fascial closure and pre-peritoneal mesh is a safe and feasible technique for groin hernia repair.

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TEP or TAPP for recurrent inguinal hernia repair—register-based comparison of the outcome

Cited by 34 publications

References 22 publications

Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair

Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair

Current Concepts of Inguinal Hernia Repair

Novel robot‐assisted laparoscopic total extra‐peritoneal repair with primary fascial closure plus pre‐peritonea mesh for large groin defects

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