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Comparison of intraocular pressure during laparoscopic totally extraperitoneal (TEP) versus transabdominal preperitoneal (TAPP) inguinal hernia repair

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Abstract

Background

Laparoscopic totally extraperitoneal (TEP) repair and transabdominal preperitoneal (TAPP) repair are standard laparoscopic procedures for inguinal hernia repair. Some evidence has shown that pneumoperitoneum can cause an increase in intraocular pressure (IOP) during surgery. This study aimed to compare intraoperative IOP following extraperitoneal CO2 insufflation with the TEP approach and intraperitoneal CO2 insufflation with the TAPP approach.

Methods

This study is a prospective cohort study. Patients who had inguinal hernias suitable for laparoscopic inguinal hernia repair were assigned to undergo the TEP or TAPP approach. We measured preoperative, intraoperative, and postoperative IOP. The IOP of the TEP and TAPP groups was evaluated using a t test. The relations between peak inspiratory pressure (PIP), mean arterial pressure (MAP), and end-tidal CO2 (EtCO2) were estimated using ANOVA. Univariate and multivariate analyses were performed to determine the factors associated with IOP.

Results

There were 50 patients in this study (TEP group n = 25, TAPP group n = 25). The change in intraoperative IOP from the preoperative measurement to the measurement after CO2 insufflation was not statistically significant in either the TEP or TAPP group (p value = 0.357). There was no significant difference in intraoperative IOP change between the TEP and TAPP groups. Intraoperative MAP and PIP were related to IOP, but intraoperative EtCO2 was not.

Conclusions

There was no significant intraoperative IOP change during laparoscopic inguinal hernia repair. Both the TEP and TAPP techniques can be performed safely without increasing intraoperative IOP.

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Funding

Faculty of medicine, Naresuan University.

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Authors and Affiliations

  1. Department of Ophthalmology, Naresuan University, Phitsanulok, Thailand

    Taniya Bhoopat

  2. Department of Surgery, Somdech Phra Pinklao Hospital, Bangkok, Thailand

    Pawan Chansaenroj

  3. Department of Surgery, Queen Sirikit Naval Hospital, Chon Buri, 20180, Thailand

    Pawan Chansaenroj

Authors
  1. Taniya Bhoopat
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Contributions

TB and PC conceived of the presented idea, developed the theory and writing research proposal. PC carried out the experiment data gathering and recording. TB processed the experimental data, performed, and verified the data analysis, drafted the manuscript and designed the tables and figure. TB and PC discussed the study results and edited the final manuscript.

Corresponding author

Correspondence to Pawan Chansaenroj.

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Conflict of interest

Bhoopat T. and Chansaenroj P. declare that they have no conflict of interest or financial ties to disclose.

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This study was reviewed and approved by the Institutional Review Board.

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Written informed consent was obtained from all individual participants included in the study.

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Bhoopat, T., Chansaenroj, P. Comparison of intraocular pressure during laparoscopic totally extraperitoneal (TEP) versus transabdominal preperitoneal (TAPP) inguinal hernia repair. Surg Endosc 36, 2018–2024 (2022). https://doi.org/10.1007/s00464-021-08487-x

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  • DOI: https://doi.org/10.1007/s00464-021-08487-x

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