Effects of transabdominal preperitoneal and totally extraperitoneal inguinal hernia repair: an update systematic review and meta-analysis of randomized controlled trials

Chen, Li-Siou; Chen, Wei-Chieh; Kang, Yi No; Wu, Chien-Chih; Tsai, L; Liu, Min-Zhe

doi:10.1007/s00464-018-6314-x

Cited by 58 publications

(48 citation statements)

References 31 publications

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“…Wei et al [41] included 10 RCTs encompassing just over 1000 patients which showed no difference in the recurrence rate between the two methods, suggesting equal efficacy of both these techniques. The latest systematic review and meta-analysis by Chen et al [42] analyzing 8 of the 16 RCTs comparing TEP vs TAPP reporting on recurrences totaling 778 patients showed no significant differences in the recurrence rate between the primary as well as primary plus recurrent hernias. The recurrence rate may not be the true recurrence rate as the follow-up duration, which is an important indicator or recurrence, was less than 5 years for several studies.…”

Section: Types Of Repair and Approachmentioning

confidence: 97%

Causes of recurrence in laparoscopic inguinal hernia repair

Siddaiah‐Subramanya

Ashrafi

Memon

et al. 2018

Hernia

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Recurrence can occur at any stage following inguinal hernia surgery. Patients' risk factors such as higher BMI, smoking, diabetes and postoperative surgical site infections increase the risk of recurrence and can be modified. Amongst the surgical factors, surgeon's experience, larger mesh with better tissue overlap and careful surgical techniques to reduce the incidence of seroma or hematoma help reduce the recurrence rate. Other factors including type of mesh and fixation of mesh have not shown any difference in the incidence of recurrence. It is hoped that future randomized controlled trials will address some of these issues and initiate preoperative management strategies to modify some of these risk factors to lower the risk of recurrence following laparoscopic inguinal herniorrhaphy.

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Section: Types Of Repair and Approachmentioning

confidence: 97%

Causes of recurrence in laparoscopic inguinal hernia repair

Siddaiah‐Subramanya

Ashrafi

Memon

et al. 2018

Hernia

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“…There are six systematic reviews and meta-analyses available for comparison of TEP with TAPP [44][45][46][47][48][49]. The systematic reviews by McCormack [44], Wake [45] and Bracale [46] did not include enough RCTs to permit direct comparison of TEP and TAPP.…”

Section: Comparison Of Tep Vs Tapp In Meta-analyses and Rctsmentioning

confidence: 99%

“…The most recent meta-analysis for comparison of TEP with TAPP by Chen [49] with 1519 randomized patients included six further RCTs by Ciftci [57], Mesci [58], Sharma [59], Günal [60], Bansal [61] and Jeelani [62]. But five of these six additional RCTs included women, recurrences or bilateral inguinal hernias [57-59, 61, 62] and therefore had to be excluded from the present analysis.…”

Section: Comparison Of Tep Vs Tapp In Meta-analyses and Rctsmentioning

confidence: 99%

TEP for elective primary unilateral inguinal hernia repair in men: what do we know?

Köckerling

2019

Hernia

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Introduction Based on the new international guidelines for groin hernia management, there is no one surgical technique that is suited to all patient characteristics and diagnostic findings. Therefore, a tailored approach should be used. Here, a distinction must be made between primary unilateral inguinal hernia in men and in women, bilateral inguinal hernia, scrotal inguinal hernia, inguinal hernia following pelvic and lower abdominal procedures, patients with severe cardiopulmonary complications, recurrent inguinal hernias and incarcerated inguinal and femoral hernias. This paper now explores the relevant studies on TEP for elective primary unilateral inguinal hernia in men, which constitutes the most common indication for repair. Material A systematic search of the available literature was performed in February 2019 using Medline, PubMed, Scopus, Embase, Springer Link and the Cochrane Library. Only meta-analyses, systematic reviews, RCTs and comparative registry studies were considered. 117 publications were identified as relevant. Results RCTs and comparative registry analyses demonstrated the advantages of TEP with regard to postoperative complications, complication-related reoperations, and postoperative and chronic pain compared with Lichtenstein repair for elective primary unilateral inguinal hernia repair in men. No relevant differences were found compared with TAPP. Mesh fixation is not needed in TEP, but heavyweight meshes result in a lower recurrence rate. Extraperitoneal bupivacaine analgesia vs placebo does not demonstrate any advantages, but drainage is advantageous for seroma prophylaxis. The risk of chronic pain is negatively influenced by small defects, younger patient age, preoperative pain, higher BMI, postoperative complications, higher ASA score and risk factors. Conclusion For the subgroup of elective primary unilateral inguinal hernia in men, accounting for a proportion of less than 50% of the total collective, advantages were identified for TEP compared with open Lichtenstein repair but not versus TAPP.

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“…Inguinal hernias account for approximately 97% of all groin hernia repairs with males representing 90% of these repairs . Inguinal hernias have been repaired through a variety of approaches with growing evidence comparing open, laparoscopic transabdominal preperitoneal, and totally extra‐peritoneal (TEP) approaches . The introduction of robotic surgery provides another emerging minimally invasive approach .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic totally extra‐peritoneal groin hernia repair with self‐gripping polyester mesh: a series of 780 repairs

Stavert

Chan

Ozmen

et al. 2019

ANZ Journal of Surgery

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Background: Laparoscopic groin hernia repair is an increasingly common procedure with benefits of reduced post-operative pain and infection. Post-operative chronic pain remains an ongoing concern in about 10% of patients. Parietex ProGrip™, a polyester self-gripping mesh, has a theoretical benefit of avoiding tacks for mesh-fixation. This case series reflects our long-term experience of this technique. Methods: We conducted a retrospective case series from November 2011 to December 2017. Patients were identified through an operative Medicare Benefits Schedule item number search. Clinical documentation was reviewed with length of stay, mesh infection, chronic pain, recurrence and re-operation as primary data points. Results: A total of 514 patients underwent 780 laparoscopic inguinal hernia repairs with self-gripping polyester mesh during this period. There were 53 female (10.3%) and 461 male patients (89.7%). Unilateral hernia repair was performed in 248 patients (48.2%) and bilateral repair in 266 patients (51.8%). Almost all repairs (779, 99.8%) were primary hernias. There were no mesh infections. Four recurrences were noted (0.51%) and three of these subsequently underwent open redo-hernia repairs (0.38%). Post-operative follow-up was up to 4.4 years. Conclusions: Our series of laparoscopic groin hernia repair with self-gripping mesh demonstrate this is a safe and reliable mesh and effective technique with low recurrence rates.

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Effects of transabdominal preperitoneal and totally extraperitoneal inguinal hernia repair: an update systematic review and meta-analysis of randomized controlled trials

Cited by 58 publications

References 31 publications

Causes of recurrence in laparoscopic inguinal hernia repair

Causes of recurrence in laparoscopic inguinal hernia repair

TEP for elective primary unilateral inguinal hernia repair in men: what do we know?

Laparoscopic totally extra‐peritoneal groin hernia repair with self‐gripping polyester mesh: a series of 780 repairs

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