Telescopic Dissection as a Cost-Effective Alternative to Balloon Trocar for Preperitoneal Dissection in Total Extraperitoneal Inguinal Hernia Repair

<b><i>Background:</i></b> Total extraperitoneal (TEP) approach is one of the commonly used minimally invasive method in inguinal hernia repair. There are limited data that compares the results of the telescopic dissection and balloon trocar for preperitoneal dissection. In our study, we aimed to retrospectively evaluate the TEP cases performed at our center and compare the results of these two techniques. <b><i>Methods:</i></b> TEP cases performed between 2020 and 2024 were evaluated. Strangulated and recurrent hernia cases were excluded. Telescopic dissection and balloon trocar techniques were compared in terms of conversion, postoperative pain, complications, and recurrence. <b><i>Results:</i></b> A total of 177 patients were included. Telescopic method was used in 122 cases, while a balloon trocar was used in 55 cases. The median age was 50 years (range: 20-86), and 163 patients (92%) were male. Bilateral inguinal hernia was present in 61 patients (35%). The median operative time was 100 minutes (IQR: 80-120 minutes). Conversion was required in a total of 3 cases (1.5%); specifically, the transabdominal preperitoneal method was employed in 2 cases, and Lichtenstein-style anterior approach hernia repair was performed in one case. Between the telescopic dissection and balloon trocar groups, no significant differences were observed in operation time (<i>P</i> = .407), conversion rates (<i>P</i> = .228), postoperative pain scores (<i>P</i> = .505, <i>P</i> = .264, <i>P</i> = .681, <i>P</i> = .743), complication rates (<i>P</i> = .205), or recurrence rates (<i>P</i> = .311). <b><i>Conclusions:</i></b> The results of using a balloon trocar and telescopic dissection in inguinal hernia repair with TEP are similar, and telescopic dissection could be a cost-effective alternative to the balloon trocar.