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Transabdominal Preperitoneal Patch Plasty (TAPP): Standard Technique and Specific Risks

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Laparo-endoscopic Hernia Surgery

Abstract

About 25 years after the first description of a reliable technique in laparoscopic inguinal hernia repair [1], the penetration rate of this new technique is still below 20% in most countries. The reasons for the slow acceptance of laparoscopic hernioplasty are firstly that the technique is estimated as difficult and time demanding, secondly that life-threatening complications are feared, and thirdly that higher costs in comparison to open surgery are expected. Most of these concerns date back to the early days of laparoscopic surgery. Meanwhile knowledge and skills have increased enormously. It is well proven that using a strictly standardized technique and being well trained, laparoscopic hernia repair may be simple, safe, and cheap to perform.

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References (in parentheses graduation of evidence)

  1. Arregui ME, Davis CJ, Yucel O, Nagan RF. Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc. 1992;2(1):53–8. (3).

    Google Scholar 

  2. Muschalla F, Schwarz J, Bittner R. Effectivity of laparoscopic inguinal hernia repair (TAPP) in daily clinical practice: early and long-term result. Surg Endosc. 2016;30(11):4985–94. [Epub ahead of print]. (3).

    Article  PubMed  Google Scholar 

  3. Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Pass C, Singh K, Timoney M, Weyhe D, Chowbey P. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society(IEHS)). Surg Endosc. 2011;25(9):2773–843. (1a).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, Buhck H, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Grimes KL, Klinge U, Koeckerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Chowbey P. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015;29(2):289–321. (1a).

    Article  CAS  PubMed  Google Scholar 

  5. Semm K. Operative pelviscopy-operative laparoscopy. In: Operative manual for endoscopic abdominal surgery. Chicago: Year Book Medical Publishers; 1985. (2c).

    Google Scholar 

  6. Stoppa RE, Rives JL, Warlaumont CR, et al. The use of Dacron in the repair of hernias of the groin. Surg Clin North Am. 1984;64:269–85. (3).

    Article  CAS  PubMed  Google Scholar 

  7. Bittner R, Leibl BJ, Ulrich M. Chirurgie der Leistenhernie. Freiburg: Karger; 2006. (2C).

    Book  Google Scholar 

  8. Ulrich M. Postoperative management. In: Bittner R, Leibl BJ, Ulrich M, editors. Chirurgie der Leistenhernie. Freiburg: Karger; 2006. p. 140–2. (2C).

    Chapter  Google Scholar 

  9. Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13:343–403. (1a).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Koch CA, Grinberg GG, Farley DR. Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg. 2006;191:381–5. (3).

    Article  PubMed  Google Scholar 

  11. Vilos GA, Vilos AG, Abu-Rafea B, Hollett-Caines J, Nikkhah-Abyaneh Z, Edris F. Three simple steps during closed laparoscopic entry may minimize major injuries. Surg Endosc. 2009;23:758–64. (4).

    Article  PubMed  Google Scholar 

  12. Schmedt CG, Leibl BJ, Däubler P, Bittner R. Access-related complications – an analysis of 6023 consecutive laparoscopic hernia repairs. Minim Invasive Ther Allied Technol. 2001;10:23–30. (2C).

    Article  Google Scholar 

  13. Shamiyeh A, Glaser K, Kratochwill H, Hörmandinger K, Fellner F, Wayand W, Zehetner J. Lifting of the umbilicus for the installation of pneumoperitoneum with the Veress needle increases the distance to the retroperitoneal and intraperitoneal structures. Surg Endosc. 2009;23:313–7. (3).

    Article  PubMed  Google Scholar 

  14. Vilos GA, Ternamian A, Dempster J, Laberge PY. The Society of Obstetricians and Gynaecologists of Canada. Laparoscopic entry: a review of techniques, technologies, and complications. J Obstet Gynaecol Can. 2007;29:433–65. (1A).

    Article  PubMed  Google Scholar 

  15. Teoh B, Sen R, Abbot J. An evaluation of four tests used to ascertain Veress needle placement at closed laparoscopy. J Minim Invasive Gynecol. 2005;12:153–8. (4).

    Article  PubMed  Google Scholar 

  16. Catarci M, Carlini M, Gentileschi P, Santoro E. Major and minor injuries during the creation of pneumoperitoneum: a multicenter study on 12,919 cases. Surg Endosc. 2001;15:566–9. (2C).

    Article  CAS  PubMed  Google Scholar 

  17. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110:886–7. (5).

    Article  CAS  PubMed  Google Scholar 

  18. Peitgen K, Nimtz K, Hellinger A, Walz MK. Open approach or Veress needle in laparoscopic interventions? Results of a prospective randomized controlled study. [Article in German]. Chirurg. 1997;68:910–3. (2B).

    Article  CAS  PubMed  Google Scholar 

  19. Agresta F, De Simone P, Ciardo LF, Bedin N. Direct trocar insertion vs Veress needle in nonobese patients undergoing laparoscopic procedures: a randomized prospective single-center study. Surg Endosc. 2004;18:1778–81. (1B).

    Article  CAS  PubMed  Google Scholar 

  20. Altun H, Banli O, Kavlakoglu B, Kücükkayikci B, Kelesoglu C, Erez N. Comparison between direct trocar and Veress needle insertion in laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A. 2007;17:709–12. (1B).

    Article  PubMed  Google Scholar 

  21. Merlin TL, Hiller JE, Maddern GJ, Jamieson GG, Brown AR, Kolbe A. Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery. Br J Surg. 2003;90:668–79. (1A).

    Article  CAS  PubMed  Google Scholar 

  22. Bittner R, Schmedt CG, Leibl BJ. Transabdominal pre-peritoneal approach. In: KA LB, editor. Laparoscopic hernia surgery. London: Arnold Publisher; 2003. p. 54–64. (2C).

    Google Scholar 

  23. Bhoyrul S, Payne J, Steffes B, Swanstrom L, Way LW. A randomized prospective study of radially expanding trocars in laparoscopic surgery. J Gastrointest Surg. 2000;4:392–7. (1B).

    Article  CAS  PubMed  Google Scholar 

  24. Lam TY, Lee SW, So HS, Kwok SP. Radially expanding trocar: a less painful alternative for laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2000;105:269–73. (2B).

    Article  Google Scholar 

  25. Yim SF, Yuen PM. Randomized double-masked comparison of radially expanding access device and conventional cutting tip trocar in laparoscopy. Obstet Gynecol. 2001;97:435–8. (1B).

    PubMed  CAS  Google Scholar 

  26. Carilli S, Alper A, Emre A. Inguinal cord lipomas. Hernia. 2004;8:252–4. (4).

    Article  CAS  PubMed  Google Scholar 

  27. Cavazzola LT, Lieberknecht M, Machado AS, Farias FR. Giant lipoma of the spermatic cord. Am J Surg. 2009;198:54–5. (4).

    Article  Google Scholar 

  28. Lau H. Recurrence following endoscopic extraperitoneal inguinal hernioplasty. Hernia. 2007;11:415–8. (4).

    Article  CAS  PubMed  Google Scholar 

  29. Lilly MC, Arregui ME. Lipomas of the cord and round ligament. Ann Surg. 2002;235:586–90. (4).

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lau H, Loong F, Yuen WK, Patil NG. Management of herniated retroperitoneal adipose tissue during endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc. 2007;21:1612–6. (3).

    Article  CAS  PubMed  Google Scholar 

  31. Nasr AO, Tormey S, Walsh TN. Lipoma of the cord and round ligament: an overlooked diagnosis? Hernia. 2005;9:245–7. (4).

    Article  PubMed  Google Scholar 

  32. Felix E, Scott S, Crafton B, Geis P, Duncan T, Sewell R, McKernan B. Causes of recurrence after laparoscopic hernioplasty. A multicenter study. Surg Endosc. 1998;12:226–31. (3).

    Article  CAS  PubMed  Google Scholar 

  33. Gersin KS, Heniford BT, Garcia-Ruiz A, Ponsky JL. Missed lipoma of the spermatic cord. A pitfall of transabdominal preperitoneal laparoscopic hernia repair. Surg Endosc. 1999;13:585–7. (3).

    Article  CAS  PubMed  Google Scholar 

  34. Reddy VM, Sutton CD, Bloxham L, Garcea G, Ubhi SS, Robertson GS. Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Hernia. 2007;11:393–6. (2B).

    Article  CAS  PubMed  Google Scholar 

  35. Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W, Veterans Affairs Cooperative Studies Program 456 Investigators. Open mesh versus laparoscopic mesh repair of ingiunal hernia. N Engl J Med. 2004;350:1819–27. (1B).

    Article  CAS  PubMed  Google Scholar 

  36. Neumayer L, Giobbi-Hurder A, Jonasson O. Open mesh versus laparoscopic mesh hernia repair (authors reply). N Engl J Med. 2004;351:1463–5. (4).

    Article  Google Scholar 

  37. Lowham AS, Filipi CJ, Fitzgibbons RJ Jr, Stoppa R, Wantz GE, Felix EL, Crafton WB. Mechanisms of hernia recurrence after preperitoneal mesh repair. Ann Surg. 1997;225:422–31. (2B).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Stengel D, Bauwens K, Ekkernkamp A. Recurrence risks in randomized trials of laparoscopic versus open inguinal hernia repair: to pool or not to pool (this is not the question). Langenbeck’s Arch Surg. 2004;389:492–8. (2A).

    Article  Google Scholar 

  39. Kapiris SA, Brough WA, Royston CM, O’Boyle C, Sedman PC. Laparoscopic transabdominal preperitoneal (TAPP) hernia repair. A 7-year two-center experience in 3017patients. Surg Endosc. 2001;15:972–5. (2C).

    Article  CAS  PubMed  Google Scholar 

  40. Arvidsson D, Berndsen FH, Larsson LG, Leijonmarck CE, Rimbaeck G, Rudberg C, Smedberg S, Spangen L, Montgomery A. Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia. Br J Surg. 2005;92(9):1085–91. (1b).

    Article  CAS  PubMed  Google Scholar 

  41. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR. Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up. Ann Surg. 2009;249(1):33–8. (1b).

    Article  PubMed  Google Scholar 

  42. Knook MT, van Rosmalen AC, Yoder BE, Kleinrensink GJ, Snijders CJ, Looman CW, van Steensel CJ. Optimal mesh size for endoscopic inguinal hernia repair, a study in a porcine model. Surg Endosc. 2001;15:1471–7. (5).

    Article  CAS  PubMed  Google Scholar 

  43. Totte E, Van Hee R, Kox E, Hendrickx L, Van Zwieten KJ. Surgical anatomy of the inguinal region: implications during inguinal laparoscopic herniorrhaphy. Eur Surg Res. 2005;37:185–90. (5).

    Article  CAS  PubMed  Google Scholar 

  44. Phillips EH, Rosenthal R, Fallas M, Carroll B, Arregui M, Corbitt J, Fitzgibbons R, Seid A, Schultz L, Toy F, et al. Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc. 1995;9:140–4. (2C).

    PubMed  CAS  Google Scholar 

  45. Leibl BJ, Kraft B, Redecke JD, Schmedt CG, Ulrich M, Kraft K, Bittner R. Are postoperative complaints and complications influenced by different techniques in fashioning and fixing the mesh in transperitoneal laparoscopic hernioplasty? Results of a prospective randomized trial. World J Surg. 2002;26:1481–4. (2B).

    Article  PubMed  Google Scholar 

  46. Leibl BJ, Schmedt C-G, Schwarz J, et al. A single institution’s experience with transperitoneal laparoscopic hernia repair. Am J Surg. 1998;175:446–52. (2C).

    Article  CAS  PubMed  Google Scholar 

  47. Bittner R, Schmedt CG, Schwarz J, Kraft K, Leibl BJ. Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg. 2002;89:1062–6. (2B).

    Article  CAS  PubMed  Google Scholar 

  48. Celik AS, Memmi N, Celebi F, Guzey D, Celik A, Kaplan R, Oncu M. Impact of slit and nonslit mesh technique on testicular perfusion and volume in the early and late postoperative period of the totally extraperitoneal preperitoneal technique in patients with inguinal hernia. Am J Surg. 2009;198:287–91. (1B).

    Article  PubMed  Google Scholar 

  49. Domniz N, Perry ZH, Lantsberg L, Avinoach E, Mizrahi S, Kirshtein B. Slit versus non-slit mesh placement in total extraperitoneal inguinal hernia repair. World J Surg. 2011;35:2382–6. (3).

    Article  PubMed  Google Scholar 

  50. Bringman S, Blomqvist P. Intestinal obstruction after inguinal and femoral hernia repair: a study of 33,275 operations during 1992–2000 in Sweden. Hernia. 2005;9:178–83. (2C).

    Article  CAS  PubMed  Google Scholar 

  51. Duran JJ, May JM, Msika S, Gaschard D, Domergue J, Gainant A, Fingerhut A. Prevalence and mechanisms of small intestinal obstruction following laparoscopic abdominal surgery. Arch Surg. 2000;135:208–12. (2C).

    Article  Google Scholar 

  52. Eugene JR, Gashti M, Curras EB, Schwartz K, Edwards J. Small bowel obstruction as a complication of laparoscopic extraperitoneal inguinal hernia repair. J Am Osteopath Assoc. 1998;98:510–1. (2C).

    PubMed  CAS  Google Scholar 

  53. Boughey JC, Nottingham JM, Walls AC. Richter’s hernia in the laparoscopic era: four case reports and review of the literature. Surg Laparosc Endosc Percutan Tech. 2003;13:55–8. (4).

    Article  PubMed  Google Scholar 

  54. Jones DB, Callery MP, Soper NJ. Strangulated incisional hernia at trocar site. Surg Laparosc Endosc. 1996;6:152–4. (4).

    Article  CAS  PubMed  Google Scholar 

  55. Di Lorenzo N, Coscarella G, Lirosi F, Gaspari A. Port-site closure: a new problem, an old device. JSLS. 2002;6:181–3. (4).

    PubMed  PubMed Central  Google Scholar 

  56. Kouba EJ, Hubbard JS, Wallen E, Pruthi RS. Incisional hernia in a 12-mm non-bladed trocar site following laparoscopic nephrectomy. Urol Int. 2007;79:276–9. (4).

    Article  PubMed  Google Scholar 

  57. Liu CD, McFadden DW. Laparoscopic port sites do not require fascial closure when nonbladed trocars are used. Am Surg. 2000;66:853–4. (4).

    PubMed  CAS  Google Scholar 

  58. Reardon PR, Preciado A, Scarborough T, Matthews B, Marti JL. Hernia at 5-mm laparoscopic port site presenting as early postoperative small bowel obstruction. J Laparoendosc Adv Surg Tech A. 1990;9:523–5. (4).

    Article  Google Scholar 

  59. Yee DS, Duel BP. Omental herniation through a 3-mm umbilical trocar site. J Endourol. 2006;20:133–4. (4).

    Article  PubMed  Google Scholar 

  60. Tonouchi H, Ohmori Y, Kobayashi M, Kusunoki M. Trocar site hernia. Arch Surg. 2004;139:1248–56. (2A).

    Article  PubMed  Google Scholar 

  61. Grant AM. EU Hernia Trialists Collaboration. Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia. 2002;6:2–10. (1A).

    Article  CAS  PubMed  Google Scholar 

  62. McCormack K, Wake BL, Fraser C, Vale L, Perez J, Grant A. Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review. Hernia. 2005;9:109–14. (1A).

    Article  CAS  PubMed  Google Scholar 

  63. Köhler G, Mayer F, Lechner M, Bittner R. Small bowel obstruction after TAPP repair caused by a self-anchoring barbed suture device for peritoneal closure: case report and review of the literature. Hernia. 2015;19(3):389–94.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Winghofer Medicum, Hernienzentrum Rottenburg a.N, Rottenburg am Neckar, Germany

    Reinhard Bittner & David Chen

  2. Visceral Surgery, NetworkHernia, Zurich, Switzerland

    Jan F. Kukleta

Authors
  1. Reinhard Bittner
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  2. Jan F. Kukleta
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Correspondence to Reinhard Bittner .

Editor information

Editors and Affiliations

  1. Em.Director of Surgical Department, Marienhospital Stuttgart, Stuttgart, Germany

    Reinhard Bittner

  2. Academic Teaching Hospital of Charitè Medical School, Vivantes Hospital, Department of Surgery and Center for Minimally Invasive Surgery, Berlin, Germany

    Ferdinand Köckerling

  3. Department of General Surgery, Creighton University School of Medicine, Omaha, Nebraska, USA

    Robert J. Fitzgibbons, Jr.

  4. Louisiana State University School of Medicine, Department of Surgery, Our Lady of the Lake Physician Group, Department of Surgery, Baton Rouge, Louisiana, USA

    Karl A. LeBlanc

  5. Norton Thoracic Institute, Dignity Health, Creighton University School of Medicine (Phoenix campus), Phoenix, Arizona, USA

    Sumeet K. Mittal

  6. Minimal Access, Metabolic and Bariatric Surgery, Max Super Specialty Hospital Saket, New Delhi, India

    Pradeep Chowbey

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Bittner, R., Kukleta, J.F., Chen, D. (2018). Transabdominal Preperitoneal Patch Plasty (TAPP): Standard Technique and Specific Risks. In: Bittner, R., Köckerling, F., Fitzgibbons, Jr., R., LeBlanc, K., Mittal, S., Chowbey, P. (eds) Laparo-endoscopic Hernia Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55493-7_9

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