Abstract:
Aim: Endoscopic inguinal hernia repair,totally extraperitoneal(TEP) and transabdominal preperitoneal(TAPP) approach are widely accepted alternatives to open surgery.The search for the \'gold standard\' repair method still continues.This retrospective clinic trial was done to compare the TEP and TAPP techniques of laparoscopic inguinal hernia repair.\r\nMaterial and Methods:This retrospective clinic study was conducted between January 2014 and december,2014 and included 62 patients suffering from uncomplicated primary groin hernia.Patients were in two groups;TEP and TAPP.The parameters were O2 saturation and end tidal CO2 values,operation time,adverse effects,postoperative assessment of pain,hospital stay and return to work period,early and late complications,patient satisfaction,recurrence and chronic pain value.\r\nResults: Sixty two patients were included into the study(TEP;26 TAPP;36).Both groups were comparable in terms of demographic and hernia characteristics.The average operation time was longer in TAPP group (p <0,001).The pain scores at 1 h,6 h,12 h and 24 h after surgery and at the 3rd-month follow-up were significantly higher in the TAPP group (p<0.05).Group TAPP had lower partial O2 saturation values compared to group TEP at 10th,20th,30th minutes and at the end of operation.End tidal CO2 values at 10th, 20th and 30th minutes were significantly higher (p<0.001).The average follow-up was 15.5 months.In the TEP group,15.38% of patients had seroma compared to 5.55% in the TAPP group (p = 0.021). However, there was a higher incidence of scrotal edema in the TAPP group (7 vs. 2, p = 0.282).There was one recurrence in TAPP group follow-up period.Generally,the patients were more satisfied with TEP rather than TAPP (p<0.05).\r\nConclusions: In the present study,TEP had a significant advantage of significantly reduced postoperative pain up to 3 months,which resulted in a better patient satisfaction score over TAPP.By manipulating CO2 insufflation appropriately,a safe laparoscopic TAPP and TEP techniques can be performed.\r\nKeywords: Inguinal Hernia,TAPP,TEP,ETCO2,
Author(s): Turgut Donmez, Oguzhan Sunamak, Sinan Uzman, Omer Karagoz