Prospective Comparative Study between Conventional TAPP and Tumescent TAPP.

Introduction: Transabdominal preperitoneal approach (cTAPP) is effective method in treatment of inguinal hernia. Technical difficulties and long learning curve are the main disadvantages. We suggest that tumescent injection inthe preperitoneal space during TAPP before dissection may facilitate technical difficulties and decrease the learningcurve with subsequent improvement of the competence of the trainee to do the surgery.Patients and methods: From March 2020 to March 2022, our study enrolled 200 patients, evenly split betweenthose receiving conventional TAPP (cTAPP) and Tumescent TAPP (tTAPP). The surgeries were performed bytrainees under supervision. The surgical procedure involved injecting a mixture of 50 ml of 0.5% Bupivacaine andadrenaline diluted to 1 in 200,000 into the extraperitoneal space. The rest of the operation was consistent with theconventional techniques of TAPP repair.Results: There was a highly significant difference between both study groups as regards operative time withhigher mean time among cTAPP cases. There was a highly significant difference between both study groupsas regards pain score 24 hours after operation with higher mean time among cTAPP cases. Yet, no significantdifference was found in pain score 2 weeks, 30 days and 1 year after operation. Regarding the competence andlearning of the trainees, there was significant difference in overall competence with favor to tTAPP group.Conclusion: The application of Tumescent technique in TAPP surgery could potentially reduce the learning curve,abbreviate the duration of the operation, and alleviate postoperative discomfort for patients when contrasted withthe traditional TAPP method.