Laparoscopic repair of inguinal hernia transabdominal preperitoneal (TAPP) versus total extraperitoneal (TEP) Techniques

Background: The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall.  Objective: The aim of this study is to compare the results of laparoscopic hernioplasty with Transabdominal pre-peritoneal (TAPP) versus Totally Extraperitoneal (TEP) as techniques for repair of inguinal hernia. Patients and Methods: In our study, 30 patients were included divided on two groups, 15 for each. Group A; underwent laparoscopic Transabdominal pre-peritoneal (TAPP) repair with mesh, Group B; underwent laparoscopic Totally Extraperitoneal (TEP) repair with mesh. Follow up of patients was done in the out-patient clinic at ain shams hospitals, 7 days after discharge then at 3, and 6 months postoperatively at the period between March 2018 and August 2018. Results: Both groups were compared in terms of operative technique, operative time, intra & post operative complications, early post operative pain within one week, hospital stay, restriction of physical activity and incidence of recurrence and chronic pain. Conclusion: Interpretation of results revealed that the TEP repair appeared technically more difficult as evidenced by increased operative time and more post operative pain in first hours. It needs a long learning curve and a dedicated team for technique excellence. However, it is preferred because it is associated with less wound-related complications, shorter hospital stay and rapid return to normal activity.