Outcomes Following Transabdominal Preperitoneal Hernioplasty: A Retrospective Study of 288 Consecutive Cases
Juan Carlos Martín-del Olmo, Pilar Concejo-Cutoli, María Luz Martín-Esteban, Cristina López-Mestanza, Jean Carlo Trujillo-Díaz, Carlos Vaquero-Puerta, Juan Ramón Gómez-López
Citation Information :
Martín-del Olmo JC, Concejo-Cutoli P, Martín-Esteban ML, López-Mestanza C, Trujillo-Díaz JC, Vaquero-Puerta C, Gómez-López JR. Outcomes Following Transabdominal Preperitoneal Hernioplasty: A Retrospective Study of 288 Consecutive Cases. World J Lap Surg 2023; 16 (2):75-79.
Aim: Surgical management of inguinal hernia (IH) through laparoscopic approaches is becoming increasingly common in surgical practice. However, there is still controversy regarding the indications and techniques used, such as totally extraperitoneal (TEP) or transabdominal preperitoneal (TAPP) repair. The purpose of this study was to evaluate the short- and long-term postoperative outcomes of TAPP hernioplasty in a series of 288 cases.
Materials and methods: A consecutive series of 288 patients who underwent laparoscopic TAPP repair between January 2006 and December 2019 were included. The inclusion criteria consisted of patients with a symptomatic bilateral hernia, recurrent hernia, suspicion of occult IH, and unilateral hernia for whom the procedure was specifically requested. Demographic data, operative details, and postoperative outcomes were registered.
Results: A total of 524 TAPP repairs were included in the study. The median operative time was 100 minutes for bilateral hernias and 75 minutes for unilateral hernias. The postoperative morbidity rate was 4.8%, and no mortalities were recorded. The median follow-up period was 21 (6–60) months. The recurrence rate at 60 months was 3.24%, and the incidence of chronic postoperative pain was 0.2%. Recurrence and neuritis were mainly associated with polyester meshes.
Conclusion: Transabdominal preperitoneal is a safe and effective surgical option for managing IHs, provided that patients and meshes are carefully selected.
Clinical significance: Nonpolyester meshes and nontraumatic fixation are associated with better outcomes.
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