Randomized Comparative Study Between Laparoscopic Transabdominal Pre-Peritoneal Versus Totally Extraperitoneal Approach in Inguinal Hernia Repair

Background: Whether totally extraperitoneal inguinal hernia repair (TEP) is associated with better outcomes than transabdominal preperitoneal inguinal hernia repair (TAPP) continues to be a matter of debate. The objective of this study is to compare outcomes between patients undergoing TEP or TAPP. Methods: This prospective randomized comparative study was carried out in Gastrointestinal and Laparoscopic Surgery Unit, General Surgery Department, Tanta University Hospitals from May 2016 to May 2017, on 30 patients with inguinal hernia, divided into 2 equal groups: Group I: subjected to Transabdominal Pre-peritoneal (TAPP) inguinal hernia repair (15 cases). Group II: subjected to Totally Extraperitoneal (TEP) inguinal hernia repair (15 cases). Results: The mean age was 47.8±10.4 ranged from 19-65 years. All patients were presented with indirect inguinal hernia. All cases were male except one female patient. Operative time was 151.7±24.8 in TAPP approach in comparison to 88.42±30.6 minutes in TEP approach. Post-operative scrotal edema was higher in TAPP approach (9 cases) in comparison to TEP approach (3cases). Postoperative Hematoma and ileus were higher in TAPP technique (2cases). Postoperative Surgical emphysema was higher in TEP technique (3cases). Hospital stay in TAPP approach was longer than TEP approach. There was no difference regarding wound infection, mesh infection and recurrence. Follow up for 6 months of all cases for complication. Conclusion: TEP approach as the laparoscopic procedure of choice for inguinal hernia repair due to short operative time and less hospital stay than TAPP approach.