Title: Comparative Study of TAPP Repair Vs Open Tension Free Inguinal Hernioplasty
Authors: Dr Vinaya K. Ambore, Dr Mayank B. Mishra
DOI: http://dx.doi.org/10.18535/jmscr/v4i9.07
Aims and Objective: Present study was conducted with objective to compare laparoscopic TAPP (Transabdominal preperitoneal) repair with open tension free repair with respect to operative time, complications, postoperative recovery. Materials and Methods: A comparative study was conducted in tertiary health care center from May 2012 to November 2014 and cases fulfilling inclusion criteria were included in study. 38 cases were operated in laparoscopic TAPP repair while 68 cases with open tension free repair and assessed for complications and postoperative recovery. Result: In the study operative time was higher for Laparoscopic TAPP repair (50 min Vs 30 min, p value <0.05), while post op complication were lower for TAPP repair (15.8 % Vs 16.2 %, p value <0.48) but difference was insignificant, chronic pain at 6 month is less for TAPP repair (0.18 Vs 1.48, p value <0.5) and time to return to normal activity was also lower for laparoscopic group (9.3 days Vs 13.8 days, p value< 0.5). Conclusion: Laparoscopic TAPP repair offers a significant advantage over open tension free hernioplasty. It was associated with less post operative pain, faster recovery and higher operative time due to learning curve with insignificant difference in early post operative complication. Thus, Laparoscopic TAPP repair should be considered for primary hernioplasty in view of lesser post operative pain and faster recovery. Keywords: Inguinal Hernia, TAPP repair, Open hernioplasty. 1. Javid PJ et al, Maingots Abdominal Operations 12th ed, Hernia, P- 123-54. 2. Jacobs D. O. Mesh repair of inguinal hernias – Redux. N Engl J Med. 2004; 350:1895-1897. 3. Liem MSL, Van der Graaf Y, Van Steensel CJ, et al. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair. NEnglJMed1997; 336:1541-47. 4. M. P. Simons, T. Aufenacker et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009; 13:4,343-403. 5. JF Patino. A history of the treatment of hernia. In Hernia 4th edition, Nyhus LM, Condon RE, editors, Philadelphia, Lippincott. 1995; 3–15. 6. W. R. Fleming, T. B. Elliott, R. McL. Jones, K. J. Hardy, Randomized clinical trial comparing totally extraperitoneal inguinal hernia repair with the Shouldice technique, University of Melbourne Department of Surgery, Austin and Repatriation Medical Centre, Austin Campus, Melbourne, Victoria 3084, Australia. 2001;88:1183-1188. 7. Arregui ME, Davis CJ, Yucel O, Nagan RF. Laparoscopic mesh repair of inguinal hernias using a preperitoneal approach: A preliminary report. Surg Laparosc Endosc. 1992; 2:53-8. 8. Laparoscopic versus open repair of groin hernia: a randomised comparison. The MRC Laparoscopic Groin Hernia Trial Group. Lancet 1999 Jul 17;354(9174):185-90. 9. Wellwood J , Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ. 1998 Jul 11;317(7151):10310. 10. Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five year follow up, BMJ 2003;326:1012. 11. Wellwood J, Sculpher MJ et al. (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. Br Med J 317: 103–110. 12. Pironi D, Open mesh technique versus laparoscopic transabdominal preperitoneal (TAPP) approach in inguinal hernia repair. Our experience, G Chir. 2008 Nov-Dec;29(11-12):497-504. 13. Bower, Steven, Moore, Barry B., Neuralgia after inguinal hernia repair, American Surgeon, 00031348. 1996; 62(8). 14. Page B, Paterson C, Young D, O'Dwyer PJ. Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 2002; 89(10): 1315-1318. 15. Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a metaanalysis of randomized controlled trials. Surg Endosc 2005; 19(2): 188-199. 16. Andersson B, Hallen M et al. Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial. Surgery 2003; 133(5): 464-472.Abstract
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