Comparative Outcomes of Transabdominal Preperitoneal and Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair: A Retrospective Cohort Study

TL;DR

This study compares two laparoscopic hernia repair techniques, TAPP and TEP, finding similar outcomes but a higher conversion rate with TEP.

Contribution

The study provides real-world comparative data on TAPP and TEP hernia repair outcomes in routine clinical practice.

Findings

TEP had a significantly higher intraoperative conversion rate compared to TAPP.

Both techniques showed similar postoperative pain, hospital stay, and complication rates.

Short-term outcomes like recurrence and chronic pain were comparable between TAPP and TEP.

Abstract

Introduction: Laparoscopic inguinal hernia repair is widely performed using either the transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) approach. Although both techniques are established, uncertainty persists regarding their relative perioperative and postoperative outcomes in routine clinical practice. The aim of the present study was to compare operative parameters, postoperative recovery, complication rates, and short-term outcomes between TAPP and TEP laparoscopic inguinal hernia repair.

Materials and methods: This retrospective cohort study included 100 adult patients who underwent elective laparoscopic inguinal hernia repair between August 2021 and April 2023. Patients were equally divided into TAPP (n = 50) and TEP (n = 50) groups. Demographic characteristics, operative details, postoperative pain, length of hospital stay, intraoperative conversion, complications, and follow-up outcomes were analyzed. Continuous variables were compared using independent samples t-tests, and categorical variables were analyzed using Fisher's exact or chi-squared tests.

Results: Baseline demographic and hernia-related characteristics were comparable between the groups. A significantly higher intraoperative conversion rate was observed in the TEP group. Operative time, postoperative pain scores, and hospital stay did not differ significantly between techniques. Rates of short-term complications, including seroma, infection, and urinary retention, were similar. Short-term outcomes, including recurrence and chronic groin pain, showed no statistically significant differences during follow-up.

Conclusion: Both TAPP and TEP laparoscopic inguinal hernia repairs demonstrated comparable safety and effectiveness. However, the higher conversion rate associated with TEP highlights its technical complexity. Technique selection should be guided by surgeon experience, patient factors, and institutional expertise.