Comparison of Total Extraperitoneal and Transabdominal Preperitoneal in Laparoscopic Inguinal Herniorrhaphy

Objective To compare the feasibility,safety,and efficiency of laparoscopic total extraperitoneal(TEP)hernia repair surgery and laparoscopic transabdominal preperitoneal(TAPP)hernia repair surgery. Methods The clinical data of 95 patients with inguinal hernia who underwent laparoscopic TEP hernia repair surgery(TEP group)and TAPP hernia repair surgery(TAPP group)from Mar. 2010 to Oct. 2013 in our hospital were retrospectively analyzed,and clinical parameters including operation time,intraoperative blood loss,postoperative hospital stay,postoperative complication,and operation cost of 2 groups were compared. Results All the procedures were successful,none of them was converted to open surgery. There was no significant difference between TEP group and TAPP group when considering operation time〔(65±16)min vs(.68±17)min〕,intraoperative blood loss〔(7.0±1.2)mL vs(.8.0±1.4)mL〕,visual pain analogue scale〔(2.0±1.1)score vs(.1.8±1.1)score〕,postoperative hospital stay〔(3.1±1.4)d vs(.3.3±1.2)d〕, and time to release to regular activities〔(4.2±1.0)d vs(.4.5±1.2)d〕,P0.05. But the operation cost of TEP group was significantly lower than that of TAPP group〔(8 033±536)yuan vs.(9 632±643)yuan,P=0.007〕. There were 6 patients(6.3%,6/95)suffered complications,3 cases in TEP group and 3 cases in TAPP group,including 3 cases of seroma or hematoma in scrotum,1 case of transient neurapraxia,and 3 cases of urinary retention. There was no significant difference in incidence rate of postoperative complication between the 2 groups(P=1.000). All patients were followed-up for 1-35 months〔(20.0±10.2) months〕 without recurrence and chronic pain. Conclusions TEP and TAPP hernia repair surgery are feasible, safe, effective, and minimally invasive technique for inguinal hernioplasty. There are advantages and disadvantages of both TAPP and TEP hernia repair surgery, but there is no statistically signifi cant difference regarding intraoperative and postoperative complications.