TAPP or TEP? Population-Based Analysis of Prospective Data on 4,552 Patients Undergoing Endoscopic Inguinal Hernia Repair
- 1.2k Downloads
Whether total extraperitoneal inguinal hernia repair (TEP) is associated with worse outcomes than transabdominal preperitoneal inguinal hernia repair (TAPP) continues to be a matter of debate. The objective of this large cohort study is to compare outcomes between patients undergoing TEP or TAPP.
Based on prospective data of the Swiss association of laparoscopic and thoracoscopic surgery, all patients undergoing unilateral TEP or TAPP between 1995 and 2006 were included. The following outcomes were compared: conversion rates, intraoperative and postoperative complications, duration of operation.
Data on 4,552 patients undergoing TEP (n = 3,457) and TAPP (n = 1,095) were collected prospectively. Average age and American Society of Anesthesiologists score were similar in the two groups. Patients undergoing TEP had a significantly higher rate of intraoperative complications (TEP 1.9 % vs. TAPP 0.9 %, p = 0.029) and surgical postoperative complications (TEP: 2.3 % vs. TAPP: 0.8 %, p = 0.003). The postoperative length of stay was longer for patients undergoing TAPP (2.9 vs. 2.3 days, p = 0.002), whereas the duration of the operation was longer for TEP (66.6 vs. 59.0 min, p < 0.001) and the conversion rate was higher (TEP 1.0 % vs. TAPP 0.2 %, p = 0.011).
This study is one of the first population-based analyses comparing TEP and TAPP in a prospective cohort of more than 4,500 patients. Intraoperative and surgical postoperative complications were significantly higher in patients undergoing TEP. TEP is also associated with longer operating times and higher conversion rates. Therefore, on a population-based level, the TAPP technique appears to be superior to the TEP repair in patients undergoing unilateral inguinal hernia repair.
KeywordsInguinal Hernia Inguinal Hernia Repair TAPP Group TAPP Technique General Postoperative Complication
This study was supported by grants from Johnson & Johnson and Covidien.
Conflict of interest
Drs. Markus Gass, Vanessa Banz, Laura Rosella, Michel Adamina, Daniel Candinas, and Ulrich Güller have no conflicts of interest or financial ties to disclose.
- 1.Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051, v–viGoogle Scholar
- 13.Lepere M, Benchetrit S, Debaert M et al (2000) A multicentric comparison of transabdominal versus totally extraperitoneal laparoscopic hernia repair using PARIETEX meshes. J Soc Laparoendosc Surg 4:147–153Google Scholar
- 15.Baca I, Schultz C, Gotzen V et al (eds) (2000) Laparoscopic inguinal hernia repair: a review of 2500 cases. Monduzzi Editore, BolognaGoogle Scholar
- 18.Gong K, Zhang N, Lu Y et al (2011) Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 25:234–239PubMedCrossRefGoogle Scholar