COMPARITIVE STUDY BETWEEN POSTOPERATIVE OUTCOME OF TRANSABDOMINAL PREPERITONEAL REPAIR VS TOTALLY EXTRAPERITONEAL REPAIR FOR INGUINAL HERNIA REPAIR

RAJKUMAR KRISHNASAMY; ILANGOVAN MUTHU KARUPPAIAH

Volume : VI, Issue : IX, September - 2017

COMPARITIVE STUDY BETWEEN POSTOPERATIVE OUTCOME OF TRANSABDOMINAL PREPERITONEAL REPAIR VS TOTALLY EXTRAPERITONEAL REPAIR FOR INGUINAL HERNIA REPAIR

Rajkumar Krishnasamy, Ilangovan Muthu Karuppaiah

Abstract :

INTRODUCTION

Hernias are among the oldest known afflictions of humankind, and surgical repair of the inguinal hernia is the most common general surgery procedure performed today. Despite the high incidence, the technical aspects of hernia repair continue to evolve.

The introduction of laparoscopic techniques opened a new era in inguinal hernia repair. As there is a scarcity of data , that directly comp� laparoscopic TAPP and laparoscopic TEP and question remain about their relative merits and risks.

This study aims to compare post- operative outcomes of TAPP and TEP directly in order to determine which method is associated with better outcomes. MATERIALS AND METHODS

The purpose of this study is to compare post- operative outcomes and clinical effectiveness between laparoscopic TAPP and laparoscopic TEP for inguinal hernia repair.Duration of study was from September 2009 to August 2011.

Age eligible for study includes l8 years to 80 years. All patients with uncomplicated symptomatic inguinal hernia attending the out- patient department of surgery will be included. Diagnosis of inguinal hernia by clinical examination. Laparoscopic inguinal hernia repair done by either TEP or TAPP approach.

RESULTS

Hernia is one of the common surgical problems presenting to our everyday outpatient department. We have been performing both TAPP and TEP procedures for hernia repair in the department. Both these procedures are well standardized. Duration of study was from September 2009 to August 2011.Age eligible for study was l8 years to 80 years. Highest incidence of the age was occur in both 30 to 40 yrs and 41 to 50 yrs,(25.33%)

In this study, the predominant type of hernia operated was indirect inguinal hernia (61.33%). Pain was the common post- operative complication and it accounts for about 6.66%. There were no serious adverse events in TEP. CONCLUSION

Totally Extra-peritoneal Repair (TEP) is preferred over Trans-abdominal Pre-peritoneal Repair (TAPP) for laparoscopic hernia repair because it preserves the peritoneal integrity and also has lesser post- operative pain. However, TEP repair has been associated with a steep learning curve. It‘s a technically demanding procedure because of the unfamiliar anatomy and requires lot of training and laparoscopic experience. A gradual shift towards TEP has been observed worldwide because of its advantages such as reduced risk of bowel injury, bowel adhesions and incisional hernia formation. Still TAPP repair holds good for huge hernia and in initial learning phase.