Virinder Kumar Bansal, Subodh Kumar, Asuri Krishna, Om Prakash, W. F. Khan, M. C. Misra. AIIMS, New Delhi
Background: Hernia surgery is one of the most common procedures worldwide. Laparoscopic mesh repair is the standard of care in the management of inguinal hernia. TEP and TAPP are standard techniques for laparoscopic repair of groin hernia. We present our experience of more than 1500 cases of laparoscopic groin hernia repair.
Methods: This study is a retrospective analysis of prospectively maintained database of all patients who underwent laparoscopic groin hernia repair in a single surgical unit from January 2004 to July 2018. Patient’s demographic profile, hernia characteristics were noted. Clinical outcomes included were operation time, intra-operative and postoperative complications, length of postoperative hospital stay, hernia recurrence, chronic pain (defined as pain that persisted for more than 3 months), recurrence, seroma and wound infections. Patients were followed up in the outpatient clinic by the attending surgeons during the postoperative course.
Results: Over ten years duration, TEP repair was performed in 915 patients and TAPP on 635. Mean age of patients was 50.7 years (range 17-86 years). Both the techniques were comparable in terms of operative time, intraoperative complications and post operative outcomes. However there was a significantly higher pain scores (p value <0.05) at 24 hours in the TAPP group. Chronic pain(>3months) score was not significantly different between the groups. The incidence of seroma was higher in TEP and scrotal edema was more common after TAPP repair. Recurrence was noted only in 7 cases. 5 patients presented with contralateral hernia and 2 patients had Sub acute interstinal obstruction in the post-operative period and one patient had mesh infection and mesh had to be removed. In 7 patients with recurrence, 3 were operated and TAPP was done. Cause of recurrence was mesh protrusion in 2 patients( light weight mesh was used), migration of mesh and medial recurrence (non fixation). 4 patients didn’t come for follow up.
Conclusion: TEP and TAPP repair are comparable and they should be considered as complementary procedures.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94385
Program Number: P591
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster