PROSPECTIVE, RANDOMAZED, COMPARATIVE, STUDY OF INGUINAL HERNIA REPAIR USING TEP AND TAPP TECHNIQUES.

Abstract

Background: Inguinal hernia is the most common external abdominal hernia.

Objective: To compare the outcome of inguinal hernia repair using TAPP and TEP techniques.

Study Design: A prospective randomized comparative study.

Participants: 100 patients aged 18 to 75 years

Methods: Study conducted after informed consent from the patients over a period of two Years. Selected patients stratified by computer-generated randomization, Group A 50 patients for TAPP technique, Group B 50 patients for TEP technique

Results: TAPP and TEP techniques were comparable with respect to age and laterality of hernia. Operating time was less in the TAPP group in both unilateral and bilateral cases; TAPP group (mean 56.1 mins in unilateral and 64.3 mins in bilateral cases) . TEP group (mean 63.2 mins in unilateral and 75.2 mins in bilateral cases, Pain scores (visual analogue scores) on post-operative day 0, 1 and 7 Significantly lower in the TAPP group both in unilateral and bilateral cases TAPP group (mean 30.4, 20.3, 7.4 in unilateral and 35.0, 22.4, 9.7 in bilateral cases) TEP group (mean 35.7, 24.7, 10.8 in unilateral and 39.6, 22.4, 9.7 in bilateral cases) The post-operative hospital stay was lower in the TAPP group (mean 2.4 days in unilateral and 2.5 days in bilateral cases) . Overall complications were 8% in the TAPP group and 14% in the TEP group. Return to work was earlier in the TAPP group (mean 13.2 days in unilateral and 15.2 days in bilateral cases) TEP group (mean 17.3 days in unilateral and 20.3 days in bilateral cases)

Conclusion: TAPP and TEP techniques are safe and reliable methods of inguinal hernia repair. TAPP technique is associated with early toleration to feeds, lesser operative time, lesser post-operative pain, lesser hospital stay, early return to usual activities and less persisting pain. TAPP technique has a lesser recurrence rate. TEP technique is costlier to the patients.