The Role of Endoscopic Extraperitoneal Herniorrhaphy: Where Do We Stand in 2005?

Abstract

Inguinal hernia repair is a common surgical procedure, but the most effective surgical technique remains controversial. The evolution of laparoscopic techniques has allowed reproduction of open preperitoneal repair via an endoscopic total extraperitoneal (TEP) approach. More recently, the advent of comprehensive training in laparoscopy has allowed TEP to continue evolving as the feasibility of this approach gains recognition as a preferable technique. Once considered very difficult to learn, TEP currently is adequately taught in many surgical training programs. This report reviews the fundamentals and details various modifications that make this procedure more desirable than open procedures and other laparoscopic techniques. A resultant decrease in operative time, cost of the procedure, and morbidity to the patient is routine. In addition, the authors review their institutional experience and examine other current evidence-based data.

Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years

“…However, now, with a decade of experience in laparoscopic hernia repair, the cost of TEP repair is comparable with that of open repair [24,25], mainly due to successful cost-reduction strategies (factors related to learning curve effects, including reduced operative time, surgical errors, unnecessary instrumentations, and materials, plus global variables including complications, postoperative pain, recurrences, and return to work).…”

Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early results

“…There was no infection or recurrence with either type of mesh. Conclusion Lightweight PP mesh is associated with significantly better outcomes in TEP inguinal herniorrhaphy as compared with heavyweight PP mesh.Keywords TEP Á Mesh Á Lightweight mesh Á Groin pain Á Postherniorrhaphy pain Á Sexual dysfunction Á Ejaculatory pain Á Mesh inguinodynia Totally extraperitoneal repair (TEP) has become a standard-of-care procedure for inguinal hernias [1]. Polypropylene and the other mesh materials used in hernia surgery help in strengthening the weakened native tissue.…”

A comparative study of three-dimensional mesh (3D mesh) and polypropylene mesh in laparoscopic inguinal hernia repairs in adults

“…Surgical dissection, mesh fixation, and mesh-induced entrapment have been cited as the potential causes of groin pain. 25 Several studies have shown that minimally invasive hernia repair (TEP, TAPP) are associated with significantly less early and chronic pain as compared with open hernia repair. 26,27 In present study, the incidence of chronic groin pain was less in 3D mesh.…”