Laparoscopic Inguinal Hernia Repair: A Comparison of Totally Extra Peritoneal (TEP) versus Trans Abdominal Pre-peritoneal (TAPP) repair Techniques in a Tertiary Care Teaching Hospital

Laparoscopic Inguinal Hernia Repair

Abstract

Background: Inguinal hernia repair is one of the most common surgical procedures performed. The methods for inguinal hernia repair have remained mostly constant for over a century until the development of synthetic mesh. Francis Usher is the inventor of polypropylene. For laparoscopic groin hernia repair, both the trans-abdominal pre-peritoneal (TAPP) and total extra peritoneal (TEP) techniques can be employed. Subjects and Methods: The study comprised a total of 76 patients. It was a non-randomized research in which patients were divided into two groups based on the surgeons preference: Group A (TAPP) and Group B (TEP). As a result, 40 patients were assigned to TAPP group A and 36 patients to TEP group B. All patients were assessed for pain at 6 hours, 12 hours, 24 hours, 1 week, 6 months, and 1 year after surgery. Results: The enlargement in the inguinal region was present in all of the individuals in the research, and it lasted anywhere from one week to six months. Pain was the presenting symptom in 16 of the TAPP patients and 11 of the TEP patients. In terms of pain as a presenting complaint, both groups were comparable, with a P value of 0.12 that was statistically insignificant. The mean VAS score for patients presenting with pain in the TAPP group was 4.02, whereas it was 3.87 for patients in the TEP group. Again, there was no statistically significant difference in the VAS scores between the two groups. Three patients in the TAPP group and two in the TEP group reported having changed bowel habits. Each group had one patient who had previously had an inguinal hernia repaired. Both groups were found to be comparable after statistical analysis. Conclusion: In this prospective non-randomized study, we compared laparoscopic TEP and TAPP repair for the standard parameters of surgery time, conversion, serious adverse event, post-operative pain, local complications, recurrence both locally and at the port site, and length of hospital stay over a one-year period. There was no other significant difference between the two treatments other than a statistically significant difference in pain at 24 hours, which was higher in the TAPP group than the TEP group.