World Journal of Surgery

, Volume 36, Issue 12, pp 2782–2786 | Cite as

TAPP or TEP? Population-Based Analysis of Prospective Data on 4,552 Patients Undergoing Endoscopic Inguinal Hernia Repair

  • Markus Gass
  • Vanessa M. Banz
  • Laura Rosella
  • Michel Adamina
  • Daniel Candinas
  • Ulrich Güller



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.


Inguinal Hernia Inguinal Hernia Repair TAPP Group TAPP Technique General Postoperative Complication 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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.


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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Markus Gass
    • 1
  • Vanessa M. Banz
    • 1
  • Laura Rosella
    • 2
  • Michel Adamina
    • 3
  • Daniel Candinas
    • 1
  • Ulrich Güller
    • 1
    • 4
  1. 1.Department of Visceral Surgery and MedicineUniversity Hospital BernBernSwitzerland
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Department of SurgeryCantonal Hospital St. GallenSt. GallenSwitzerland
  4. 4.Department of Medical Oncology & HematologyCantonal Hospital St. GallenSt. GallenSwitzerland

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