Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) for Inguinal Hernia: The First 1,000 Patients

Lange, J; Lange, Max; Voropai, D. A.; Tilburg, Marc W. A. van; Pierie, J. P. E. N.; Ploeg, Rutger J.; Akkersdijk, W.L.

doi:10.1007/s00268-014-2475-5

Cited by 21 publications

(18 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The theoretical low percentages of pain following the TREPP procedure, as seen in previous cohorts [11,13] was not seen in this study. This relatively high percentage could be explained partly by a theoretical learning curve effect.…”

Section: Discussioncontrasting

confidence: 69%

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique: a propensity-score-matched analysis in Dutch high-volume regional hospitals

Zwols

Slagter

Veeger

et al. 2020

Hernia

Self Cite

View full text Add to dashboard Cite

Purpose Results of the most commonly used inguinal hernia repair techniques often originate from expert centers or from randomized controlled studies. In this study, we portray daily-practice results of a high-volume, regional surgical group in the Netherlands, comparing TREPP (open (posterior) transrectus sheath pre-peritoneal) with Lichtenstein (open anterior) and TEP (endoscopic (posterior) totally extraperitoneal). We hypothesize that the TREPP shows more favorable outcome compared to the current gold standard procedures: TEP and Lichtenstein. Methods Between January 2016 and December 2018, 3285 consecutive patients underwent surgical treatment and were included for analysis. The outcome measures were postoperative pain, recurrence rate and other surgical complications. Propensity-score matching was used to address potential selection bias. Results After propensity-score matching, there was no statistically significant difference in postoperative pain in the TREPP group compared to the Lichtenstein group (TREPP 7.3% versus Lichtenstein 6.3%; p = 0.67) nor in TREPP compared to TEP (TREPP 7.4% versus TEP 4.1%; p = 0.064). There was no statistically significant difference in recurrences in the TREPP group compared to Lichtenstein (3.8% vs 2.5%; p = 0.42), nor in the TREPP versus TEP comparison (3.9% vs 2.8%; p = 0.55) Conclusion This study compares TREPP with Lichtenstein and TEP in the presence of postoperative pain, recurrences and other adverse outcomes. After propensity-score matching, no statistically significant difference in postoperative pain or recurrences remained between either TREPP compared to Lichtenstein, or TREPP compared to TEP. Based on these results, TREPP, Lichtenstein and TEP showed comparable results in postoperative pain, recurrences and other surgical site complications.

show abstract

Section: Discussioncontrasting

confidence: 69%

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique: a propensity-score-matched analysis in Dutch high-volume regional hospitals

Zwols

Slagter

Veeger

et al. 2020

Hernia

Self Cite

View full text Add to dashboard Cite

show abstract

“…With a 1b level of evidence (LoE), 23 this trial is the first to confirm the earlier published promising results after TREPP 8 – 12 and good results after TIPP surgery. 4 , 5 Retrospective TREPP studies report CPIP rates of 1.7% 10 and 5.3% 9 (LoE 3b-4) and recurrence rates of 1.2%, 9 1.7% 10 and 3.9% 11 (LoE 3b-4) with significant follow-up variation (2 weeks–2 years). The more extensive evidence on TIPP surgery, mainly compared to Lichtenstein's technique, shows <5% CPIP rates (LoE 1b–2b), 4 , 5 , 24 – 26 ∼3% recurrence rates (LoE 1b-2b), 4 , 5 , 24 , 25 , 27 and quicker recovery.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Some studies found lower short-term pain scores after TIPP when compared to Lichtenstein's (LoE 1b–2b) 25 , 27 and good long-term results were reported (LoE 1b). 28 Some data show a lower percentage persisting numbness after preperitoneal repair (TREPP 15.3% LoE 4 9 , TIPP 10.6% LoE 1b 5 , TEP 4.3% 29 ) compared to Lichtenstein (12.5%–51.0% LoE 1a-b 3 , 5 ); however, data are scarce.…”

Section: Discussionmentioning

confidence: 99%

Open Preperitoneal Inguinal Hernia Repair, TREPP Versus TIPP in a Randomized Clinical Trial

et al. 2021

View full text Add to dashboard Cite

Objective: The aim of this study was to compare chronic postoperative inguinal pain (CPIP) in patients with an inguinal hernia after the TransREctus Sheath PrePeritoneal (TREPP) and the TransInguinal PrePeritoneal Technique (TIPP). Background: The preperitoneal mesh position for inguinal hernia repair showed beneficial results regarding CPIP with low recurrence rates. Two open preperitoneal techniques, TREPP and TIPP, were compared in a randomized clinical trial with the hypothesis of fewer patients with CPIP after TREPP due to complete avoidance of nerve contact. Methods: Adult patients with a primary unilateral inguinal hernia were randomized to either TREPP or TIPP in four hospitals. Before the trial's start the study protocol was ethically approved and published. Outcomes included CPIP after 1 year (primary outcome) and recurrence rates, adverse events, and health-related quality of life (secondary outcomes). Follow-up was performed at 2 weeks, 6 months, and 1 year. Results: Baseline characteristics were comparable in both groups. Pain was less often present after TREPP at 2 weeks and 6 months, but CPIP at rest at 1 year was comparable: 1.9% after TREPP vs 1.4% after TIPP, P = 0.535). The overall recurrence rate was higher in the TREPP group, 8.9% vs 4.6%, P = 0.022). Corrected for a learning curve for TREPP, no significant difference could be assessed (TREPP 5.7% and TIPP 4.8%, P = 0.591). Conclusion: Both the TREPP and TIPP technique resulted in a low incidence of CPIP after 1-year follow-up. The TREPP method can be considered a solid method for inguinal hernia repair if expertise is present. The learning curve of the TREPP techniques needs further evaluation. Trial Registration: ISRCTN18591339

show abstract

“…Encuentran conclusiones similares tras hernioplastias inguinales recidivadas: la reparación endoscópica produce menos dolor que la vía anterior -y añaden-los cirujanos con más de 5 reparaciones por vía posterior preperitoneal abierta reducen el riesgo de neuropatía crónica 104 . Otros grupos 105,106 empleando un abordaje preperitoneal posterior abierto, similar al del autor 107,108 , -empleado y publicado 22 años antes-, no encuentran prácticamente inguinodinias, (como en nuestra extensa serie), y sí ventajas sobre la vía anterior y la endoscópica TEP.…”

Section: El Abordaje Posterior Preperitoneal Abierto ¿Puede Ser Un Aunclassified

Dermatome mapping test (DMT) and it’s place on triple and selective neurectomy in patients with post-operative chronic inguinal pain

Quintero¹

2019

Rev Hispanoam Hernia

View full text Add to dashboard Cite

El dolor inguinal posoperatorio crónico (somático o neuropático) es la secuela más frecuente, importante y limitante de la cirugía herniaria inguinal, cuya prevalencia exacta se desconoce. El trabajo expone, bajo una visión personal, sinóptica y objetiva, algunas connotaciones sobre la génesis de los tipos de dolor inguinal, especialmente el neuropático, generado por la agresión técnica (invasividad, disectividad y reparatividad), sobre áreas anatómicas específicas por las que discurren los correspondientes nervios inguinales periféricos, expuestos a riesgos neurolesivos por posibles maniobras inapropiadas. Para mejorar la comprensión de la agresividad tisular y de la posible potencialidad neurolesiva de las técnicas hernioplásticas, se aportan 2 clasificaciones (personales, inéditas, intuitivas y objetivas). La primera, relaciona a grupos y modelos hernioplásticos con la dimensión cuantitativa (cm) y la extensión cualitativa de la invasividad (maxi, normo, mini o mínimamente invasivas), así como la extensión cualitativa (maxi, normo y minidisectivas) y la dimensión cuantitativa de la disectividad (superficie y volumen disectivo de técnicas abiertas y videoasistidas). La segunda clasificación relaciona a los mismos grupos y modelos técnicos con sus respectivas potencialidades neurolesivas sobre las respectivas áreas críticas de riesgo de dolor crónico neuropático, según el probable o improbable riesgo de lesionar determinados nervios en dichas áreas anatómicas, identificando además el posible efecto profiláctico que pudieran ejercer algunas de las opciones técnicas en la prevención del dolor crónico neuropático. Sin duda, es la experiencia, la pericia y la maestría técnico-científica del cirujano, la mejor profilaxis de la inguinodinia.

show abstract

Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) for Inguinal Hernia: The First 1,000 Patients

Abstract: TREPP has proven to be a feasible new technique for inguinal hernia repair, with excellent results, justifying a randomized controlled trial in which TREPP should be compared with standard techniques.

Cited by 21 publications

References 51 publications

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique: a propensity-score-matched analysis in Dutch high-volume regional hospitals

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique: a propensity-score-matched analysis in Dutch high-volume regional hospitals

Open Preperitoneal Inguinal Hernia Repair, TREPP Versus TIPP in a Randomized Clinical Trial

Dermatome mapping test (DMT) and it’s place on triple and selective neurectomy in patients with post-operative chronic inguinal pain

Contact Info

Product

Resources

About