The Outcome of Totally Extra-Peritoneal (TEP) Mesh Repair Among Patients with Unilateral Primary Inguinal Hernia: A Single Center Experience
Outcome of Totally Extra-Peritoneal (TEP) Mesh Repair Among Patients with Unilateral Primary Inguinal Hernia
Abstract
Introduction: Inguinal hernias were conventionally treated with open methods like hernioplasty and herniorrhaphy. However, with the development in minimal access surgery, the trends have changed and surgeons are also performing the TEP and TAPP laparoscopic hernia repair routinely. Hence, a retrospective study was performed to assess the safety, feasibility, and associated complications of the TEP laparoscopic hernia repair.Methods: A single institution, single unit retrospective study of all TEP hernia repair was performed at the department of surgery from May 2020 to April 2021. Data of all patients undergoing TEP were obtained from a proforma attached to the case file during patients’ admission and was analyzed.
Results: A total number of 30 patients underwent the TEP laparoscopic hernia repair during the study period. Age group ranged from 25 years to 80 years and a male preponderance was noted with all patients being male. Per operative findings of indirect hernia was noted in 27, and direct hernia in 3 patients. The mean operating time was 76.23 ± 13.53 minutes. Complications encountered in the post-operative period were seroma in one patient, and wound erythema in two patients. The mean hospital stay was 1.6 ± 0.72 days.
Conclusion: Totally Extra-peritoneal (TEP) laparoscopic repair can be performed and has all the established benefits of minimal access surgery among patients with primary unilateral inguinal hernia.
References
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26. Pokorny H, Klingler A, Schmid T, Fortelny R, Hollinsky C, Kawji R, et al. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia. 2008 Aug;12(4):385-9.
27. Rayamajhi BB, Basukala S, Thapa N, Ayer D, Karki S, Basukala B. A Comparison of outcome between Transabdominal Preperitoneal (TAPP) and Lichtenstein operation for primary inguinal hernia repair–An institutional study. J Soc Surg Nep. 2022;25(1).
2. Zendejas B, Ramirez T, Jones T, Kuchena A, Ali SM, Hernandez-Irizarry R, et al. Incidence of inguinal hernia repairs in Olmsted County, MN: a population-based study. Ann Surg. 2013 Mar;257(3):520.
3. Hernia Surge Group. International guidelines for groin hernia management. Hernia 22(1), 1-165.(2018).
4. Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, et al. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2014 Apr;18(2):151-63.
5. MRC Laparoscopic Groin Hernia Trial Group. Laparoscopic versus open repair of groin hernia: a randomized comparison. The Lancet. 1999 Jul 17;354(9174):185-90.
6. Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons Jr R, Dunlop D, Gibbs J, Reda D, Henderson W. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med . 2004 Apr 29;350(18):1819-27.
7. Ger R, Monroe K, Duvivier R, Mishrick A. Management of indirect inguinal hernias by laparoscopic closure of the neck of the sac. "Am. J. Surg."1990 Apr 1;159(4):370-3.
8. Stoppa RE, Warlaumont CR, Verhaeghe PJ, Romero ER, M’Balla-N’Di CJ. Prosthetic repair in the treatment of groin hernias. Int Surg. 1986;71(3) : 154-158.
9. Arregui MR, Davis CD, Yucel O, Nagan RF. Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 992;2:53–58.
10. McKernan JB, Laws HL. Laproscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endos. 1993;7 (1) : 26-28.
11. McCormack K. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst. Rev. 2003;1: CD001785.
12. Leibl BJ, Jäger C, Kraft B, Kraft K, Schwarz J, Ulrich M, et al. Laparoscopic hernia repair—TAPP or/and TEP?. Langenbeck's Archives of Surgery. 2005 Apr;390(2):77-82.
13. McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Conchrane Database Syst Rev 2003:CD001785.
14. Johansson B, Hallerback B, Glise H, Anesten B, Smedberg S, Roman J. Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair :a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg. 1999; 230:225-31.
15. Rutkow IM, Robbins AW. Demographic, Classificatory, and Scocioeconomic Aspects of Hernia Repair in the United States. Surg Clin North Am. 1993;73 (3):413-26.
16. Malla S, Rayamajhi J, Bhat PS, Amatya BR, Rawal SB. Laparoscopic Groin Hernia Repair with TAPP: Experience at Nepal Army Hospital. MJSBH. 2018; 17(1): 31-7.
17. Jakhmola CK, Kumar A. Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study. Med J Armed Forces India. 2015;71(4):317-23.
18. O’Donnell FL, Taubman SB. Incidence of abdominal hernias in service members, active component, U.S. Armed Forces, 2005-2014. MSMR. 2016;23(8):2-10.
19. Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc Other Interv Tech. 2004;18 (2):221-7. Available from:
20. Fitzgibbons RJ, Forse RA. Groin hernias in Adults. N Engl J Med . 2015 Feb 18;372(8):756-63.
21. Shakya VC, Sood S, Bhattarai BK, Agarwal CS, Adhikary S. Laparoscopic inguinal hernia repair: a prospective evaluation at Eastern Nepal. Pan Med J. 2014;17:241.
22. Swanstorm LL. Laparoscopic Herniorrhaphy: Surg Clin North Am. 1996;76 (489)
23. Lau H, Patil NG, Yuen WK, Lee F. Management of peritoneal tear during endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc. 2002 Oct;16(10):1474-7.
24. Swadia ND. Laparoscopic totally extra-peritoneal inguinal hernia repair: 9 years’ experience. Hernia. 2011;15:273–279.
25. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc. 2009;23:482–486.
26. Pokorny H, Klingler A, Schmid T, Fortelny R, Hollinsky C, Kawji R, et al. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia. 2008 Aug;12(4):385-9.
27. Rayamajhi BB, Basukala S, Thapa N, Ayer D, Karki S, Basukala B. A Comparison of outcome between Transabdominal Preperitoneal (TAPP) and Lichtenstein operation for primary inguinal hernia repair–An institutional study. J Soc Surg Nep. 2022;25(1).
Published
2023-08-15
How to Cite
SHAH, Kunda Bikram et al.
The Outcome of Totally Extra-Peritoneal (TEP) Mesh Repair Among Patients with Unilateral Primary Inguinal Hernia: A Single Center Experience.
J Soc Surg Nep, [S.l.], v. 26, n. 1, p. 29-33, aug. 2023.
ISSN 2392-4772.
Available at: <https://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=541>. Date accessed: 03 dec. 2024.
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