Transabdominal Preperitoneal (TAPP) Compared to Totally Extraperitoneal (TEP) for Primary Inguinal Hernia Repair in a Military Hospital: A Retrospective Cohort Study

Background: Inguinal hernias are encountered commonly, but there is a lack of uniformity and standardization in repair techniques. There are a variety of repair methods, from open methods to laparoscopic approaches. The available laparoscopic techniques that exist for inguinal hernia repair are transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair. This study aims to compare the outcomes of these two laparoscopic procedures.

Methods: The study was initiated after receiving ethical clearance. This single-centric retrospective study included the patients that underwent laparoscopic inguinal hernia repair from January 1, 2020, to December 31, 2023. Patient records were reviewed and assessed against the inclusion criteria of the study. Systematic random sampling was applied to select patients from the records. A structured questionnaire was prepared for the purpose of data collection. The data were refined and analyzed using the SPSS software.

Results: A total of 200 patients (100 in each group) who underwent laparoscopic repair of an inguinal hernia were part of this study. The median (IQR) age of patients in the TAPP group was 50 (41.25-64.75) years, and that in the TEP group was 48.5 (39.25-64.75) years. The TAPP procedure took a median (IQR) time of 81 (77-88) min, while the TEP procedure took 69 (66-73) min to finish. The patients in the TAPP group returned to their normal activities after 15 (14-16) days of surgery, and the patients in the TEP group returned after 13 (11-14) days. The pain score at 1 week was found to be better in the TEP group. No difference was observed in complications or recurrence.

Conclusion: TEP repair was found to be superior to TAPP repair in terms of procedural time, return to normal activities, and pain score at 1 week.