Background: Laparoscopic TEP and TAPP are the commonly performed methods of laparoscopic repair of inguinal hernia. Lack of documentation and inadequate follow-up have made the learning curve of TEP and TAPP all the more steep thus... more
Background: Laparoscopic TEP and TAPP are the commonly performed methods of laparoscopic repair of inguinal hernia. Lack of documentation and inadequate follow-up have made the learning curve of TEP and TAPP all the more steep thus delaying the standardization of the procedure. The aim of our study is to compare transabdominal preperitoneal mesh repair and total extra-peritoneal repair of inguinal hernia based on post operative pain, duration of Operation, conversion rates to open method, complications of each procedure, duration of stay in hospital, duration required to get back to normal activities, patient satisfaction, recurrence rates, safety and efficacy of either procedures.
Methods: A prospective, open label, comparative, hospital based single centred study was conducted among 90 patients attending general surgery OPD, K.R. Hospital attached to Mysore medical college and research institute, Mysore over a period of 2 years. All patients aged 18 years and above diagnosed with inguinal hernia were included in the study. Patients with failed laparoscopic inguinal hernia and complicated inguinal hernias which required emergency exploration were excluded from the study. Descriptive statistics, student t-test and chi-square or fischer exact test were used to analyse the results.
Results: The mean age of study subjects was 49.46+/-7.38 years. The mean operative time required for TAPP 88 minutes and TEP was 70 minutes. 66.7% of the TAPP patients had a pain score of 1 to 2 and 80% of the TEP patients had pain score of 1 to 2 according to visual analogue scale. The hospital stay in TAPP was 2.27 days and 2.53 days in TEP. Recovery period in TAPP was 6.43 days and 7.20 days for TEP.
Conclusion: Laparoscopic Total Extra-Peritoneal (TEP) mesh repair and Trans Abdominal Pre-Peritoneal (TAPP) mesh repair of inguinal hernia are both safe and efficacious, but long term Randomised Control Trials with enhanced sample size and reduced confounding factors are still required to establish the absolute superiority of TEP over TAPP.
