A PROSPECTIVE COMPARATIVE STUDY BETWEEN TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) AND TOTALLY EXTRA-PERITONEAL (TEP) LAPAROSCOPIC INGUINAL HERNIA REPAIR

Abstract

Introduction: Minimally invasive techniques for inguinal hernia repair are gaining acceptance in the general population. The two well-known minimally invasive laparoscopic approaches are Trans-Abdominal Pre Peritoneal (TAPP) and Totally Extra Peritoneal (TEP) Inguinal Hernia Repair worldwide.Objective: The objective of this study was to compare factors pertaining to laparoscopicTAPP and TEPinguinal hernia repair approaches in terms of duration of the procedure, intraoperative conversion rate, postoperative complication rate and duration of hospitalization. Design: Comparative study. Place of study: Liaquat University Hospital Jamshoro and Minimal Invasive Surgical Centre Jamshoro. Duration of study: 6 months. Methodology: A total of 136 Inguinal Hernia were selected in this study and operated randomly by either Trans-abdominal Pre-peritoneal (TAPP) or Totally Extra-peritoneal (TEP) approach. The patient's follow-up was done for 3 weeks for proper assessment of postoperative complications. Results: The mean age of patients inTAPP groupwas 49.9 ± 12.0 and the mean age of patients in TEP group was 45.8 ± 11.2 years. No significant difference was observed in age between both groups. The mean surgery time in TEP groupwas significantly higher as compared to the TAPP group (p =0.027) while the rate of conversion, complication rate and mean hospital stay were not statisticallysignificant between both groups. There was no statistically significant difference in mean pain score between groups at 12 hours, 24 hours and 48 hours. Conclusion:It has been observed that there is no significant difference in TEP and TAPP techniques used for inguinal hernia repair in terms of outcome such as rate of conversion, complication rate, pain score and mean hospital stay. This study did not show any preference for one technique over the other therefore it is the surgeon’s choice who can select the technique according to his expertise and skills.