The Outcomes of Transabdominal Preperitoneal Repair for Groin Hernias In a Single Consultant Series

TL;DR

This study evaluates the safety and outcomes of laparoscopic transabdominal preperitoneal hernia repair using mesh, finding it to be a safe and effective option with low complication rates.

Contribution

The study provides a single-consultant series analysis of TAPP hernia repair outcomes, comparing them to existing literature.

Findings

TAPP repair had a low conversion rate to open surgery and no major complications.

Chronic pain and recurrence rates were comparable to published data.

Postoperative complications like seroma and scrotal swelling occurred in 12.9% of cases.

Abstract

Background

Inguinal hernia repair is one of the most commonly performed operations in general surgery. The laparoscopic transabdominal preperitoneal approach gives a better view of the inguinal anatomy, and the procedure also has a short learning curve. We aim to evaluate the safety and outcomes of laparoscopic transabdominal preperitoneal (TAPP) repair using the synthetic mesh in a single consultant series and compare the outcomes with the available literature.

Methods

Retrospective evaluation of the outcomes was carried out on all patients who underwent laparoscopic TAPP repair from September 2018 to June 2024 by analyzing the postoperative morbidity, which includes postoperative complications, seroma, hematoma, wound infection, recurrence, post op chronic pain persisting beyond three months, and representation. Data was analyzed from the electronic patient records (EPR) and assessment of the chronic pain via assessing the available clinic follow-ups on EPR and the telephonic interviews using the European Registry for the Abdominal Wall Hernias of Life (EuraHS-Qol) questionnaire.

Results

A total of 140 patients underwent elective TAPP repairs. One hundred and eight (77.1%) were male and 32 (22.8%) were female. The median age was 54 years (range 22-89). Forty-one (29.2%) patients underwent bilateral repair, and three patients were found to have a femoral hernia. None of the cases required conversion to open repair. Seventy-eight (55.7%) patients were successfully contacted for a telephonic interview (mean duration six to eight minutes) to assess chronic pain and its impact on daily activity. Twelve (8.57%) patients reported some degree of discomfort, of whom eight (5.7%) reported chronic pain at rest with exacerbation on activity. Eighteen (12.9%) patients had postoperative complications (seroma, scrotal swelling, wound infection). Three patients required clinic or hot-clinic follow-up for hematomas. Median length of stay was one day. Readmission rate for postoperative scrotal swelling secondary to seroma was 9.4%. Two (1.42%) patients had recurrence at 12-14 months and subsequently underwent open repair.

Conclusion

The primary outcomes of chronic postoperative pain, recurrence rate, and postoperative morbidity were comparable to the available literature. There was no conversion to open in our study. However, there were no major complications, making TAPP repair a safe choice for day case surgery.