Laparoscopic Trans-Abdominal Pre-Peritoneal (TAPP) Mesh Repair Verses Total Extra-Peritoneal (TEP) Mesh Repair of Inguinal Hernia-A Comparative Study

SatishV; Bhagavan BC; SridharS

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RGUHS Nat. J. Pub. Heal. Sci Vol: 14 Issue: 4 eISSN: pISSN

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Original Article

Laparoscopic Trans-Abdominal Pre-Peritoneal (TAPP) Mesh Repair Verses Total Extra-Peritoneal (TEP) Mesh Repair of Inguinal Hernia-A Comparative Study

Satish.V¹, Bhagavan B.C², Sridhar.S³

31 .Professor and Head,

2.Professor,

3.Assistant Professor

at Kempegowda Institute of Medical Sciences Hospital & Research Centre, Bangalore

Year: 2011, Volume: 1, Issue: 1, Page no. 17-20,

Views: 838, Downloads: 7

Licensing Information:

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.

Abstract

Laparoscopic TEP and TAPP are the commonly performed methods of laparoscopic repair of inguinal hernia. Lack of documentation and inadequate followup have made the learning curve of TEP and TAPP all the more steep thus delaying the standardisation of the procedure and also making the choice of procedure a difficult and a controversial one.

Objectives: The Objective of this study is to compare the following parameters in patients undergoing TEP and TAPP, Duration of Operation, Conversion rates to open method. Post-operative pain, Complications of each procedure, Duration of stay in hospital, Duration required to get back to normal activities, Patient satisfaction, Cost effectiveness, Recurrence rates, Safety and efficacy of either procedures.

Materials and Methods: The data forthis prospective study was obtained from 60 patients undergoing Laparoscopic hemioplasty (30 from TEP and 30 from TAPP) in Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bangalore, between December 2007 and November 2009 and followed .Consent for the procedure was obtained. TEP and TAPP procedures were performed under both General Anaesthesia and Regional Anaesthesia using Polypropylene mesh.

Results: The mean operative time was less in TEP group. The pain score, hospital stay and return to normal activities were less in TEP group. There were no major complications and no recurrence.

Conclusion: Our study supports the view that laparoscopic TEP and TAPP mesh repair of inguinal hernia is 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. Learning curve for TAPP is shorter than TEP. Procedure is good and suitable for bilateral hernia repair.

<p style="margin: 1em 0px; text-align: justify; font-family: 'Proxima Nova Regular', 'Helvetica Neue', Calibri, 'Droid Sans', Helvetica, Arial, sans-serif; font-size: 15px; background-color: #ffffff; line-height: 1.5em !important;">Laparoscopic TEP and TAPP are the commonly performed methods of laparoscopic repair of inguinal hernia. Lack of documentation and inadequate followup have made the learning curve of TEP and TAPP all the more steep thus delaying the standardisation of the procedure and also making the choice of procedure a difficult and a controversial one. <p style="margin: 1em 0px; text-align: justify; font-family: 'Proxima Nova Regular', 'Helvetica Neue', Calibri, 'Droid Sans', Helvetica, Arial, sans-serif; font-size: 15px; background-color: #ffffff; line-height: 1.5em !important;">Objectives: The Objective of this study is to compare the following parameters in patients undergoing TEP and TAPP, Duration of Operation, Conversion rates to open method. Post-operative pain, Complications of each procedure, Duration of stay in hospital, Duration required to get back to normal activities, Patient satisfaction, Cost effectiveness, Recurrence rates, Safety and efficacy of either procedures. <p style="margin: 1em 0px; text-align: justify; font-family: 'Proxima Nova Regular', 'Helvetica Neue', Calibri, 'Droid Sans', Helvetica, Arial, sans-serif; font-size: 15px; background-color: #ffffff; line-height: 1.5em !important;">Materials and Methods: The data forthis prospective study was obtained from 60 patients undergoing Laparoscopic hemioplasty (30 from TEP and 30 from TAPP) in Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bangalore, between December 2007 and November 2009 and followed .Consent for the procedure was obtained. TEP and TAPP procedures were performed under both General Anaesthesia and Regional Anaesthesia using Polypropylene mesh. <p style="margin: 1em 0px; text-align: justify; font-family: 'Proxima Nova Regular', 'Helvetica Neue', Calibri, 'Droid Sans', Helvetica, Arial, sans-serif; font-size: 15px; background-color: #ffffff; line-height: 1.5em !important;">Results: The mean operative time was less in TEP group. The pain score, hospital stay and return to normal activities were less in TEP group. There were no major complications and no recurrence. <p style="margin: 1em 0px; text-align: justify; font-family: 'Proxima Nova Regular', 'Helvetica Neue', Calibri, 'Droid Sans', Helvetica, Arial, sans-serif; font-size: 15px; background-color: #ffffff; line-height: 1.5em !important;">Conclusion: Our study supports the view that laparoscopic TEP and TAPP mesh repair of inguinal hernia is 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. Learning curve for TAPP is shorter than TEP. Procedure is good and suitable for bilateral hernia repair.

Keywords

TAPP, TEP, Laparoscopic Hernia Repair

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