Laparoscopic hernia repair?TAPP or/and TEP?

The findings showed that endoscopic TEP repair is associated with longer surgery time, shorter postoperative hospital stay, earlier return to work, and recurrence rates similar to those for open inguinal hernia repair. The procedure involves greater expenses for hospitals, but appears to be cost effective from a societal perspective. The TEP technique is a serious option for mesh repair of primary hernias.

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“…Endoscopic TEP repair tends to be superior to TAPP repair, because of less morbidity as well as lower recurrence rates and complications [48,49].…”

Section: Discussionmentioning

confidence: 99%

Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review

et al. 2007

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“…Several laparoscopic techniques have been described to manage groin hernias [4][5][6][7]. Of various endoscopic hernia repair procedures, transabdominal preperitoneal repair (TAPP) [8] and totally extraperitoneal (TEP) [9] repair have been selected for routine use [10]. There are numerous indications for both procedures, whereby the TAPP approach has also been advocated for recurrent and complicated hernias (sliding or incarcerated inguinal hernias) [10].…”

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confidence: 99%

Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases

2009

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“…Only one study to date has compared TEP to TAPP repairs, and this study favors the TAPP repair for its ease of performance. This study, however, was based on a review of current literature and not on a trial [8]. A recent large randomized trial demonstrated that laparoscopic repairs had minimal impact on postoperative pain and convalescence, but included recurrent and bilateral repairs, again without blinding [6].…”

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confidence: 99%

The economic impact of laparoscopic inguinal hernia repair: results of a double-blinded, prospective, randomized trial

et al. 2007

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For this study, 66 patients with a preoperative diagnosis of unilateral primary inguinal hernia were randomized to undergo laparoscopic totally extra peritoneal (TEP), laparoscopic transabdominal (TAPP), or open inguinal hernia repair with polypropylene mesh (Lichtenstein type). Both the operative team caring for the patient postoperatively and the patient were blinded to the operative approach by placement of a large dressing covering the abdomen, which was not removed until postoperative day 3. The patients recorded their pain level on a visual analog pain scale daily. Medication usage also was recorded. All patients were seen at 7-day intervals until they returned to work. The patients were interviewed during their postoperative visits by an investigator blinded to the operative approach and questioned regarding their ability to return to work and their pain levels. The average number of lost work days in all the groups was 12, and there was no significant difference between the three groups (p = 0.074). The average operating time for the TAPP procedure was 59 min, less than the time required to complete either the TEP or the Lichtenstein approach, which had equivalent operative times (p = 0.027). The material cost was significantly lower for the Lichtenstein repair (1,200 dollars less) than for either of the laparoscopic approaches, a saving primarily related to consumable operating room supplies. The TEP repair costs were minimally higher than those for the TAPP repair (125 dollars more). No significant differences were noted in the postoperative pain scales, and the use of postoperative oral analgesics was equivalent. The higher operative costs noted for the laparoscopic hernia repairs were not offset by a shortened convalescence. Postoperative pain appears to be equivalent regardless of the operative approach chosen and is easily managed with oral analgesics.

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Laparoscopic hernia repair?TAPP or/and TEP?

Abstract: Randomised trials comparing both methods of hernia repair are lacking. Seven non-randomised studies showed no differences in recurrence rate and morbidity. In general the learning curve for is shorter in favour of TAPP repair.

Cited by 59 publications

References 50 publications

Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review

Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review

Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases

The economic impact of laparoscopic inguinal hernia repair: results of a double-blinded, prospective, randomized trial

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