A prospective randomized pilot study comparing transabdominal preperitoneal versus totally extraperitoneal laparoscopic inguinal hernioplasty in recurrent inguinal hernia

Background: Inguinal hernia repair is one of the most common surgeries. About 20% of cases with primary inguinalhernia underwent minimally invasive procedure. Recurrent inguinal hernia (RIH) after minimally invasive surgery hasbeen recorded in about 2% of cases for totally extraperitoneal (TEP) as well as for transabdominal preperitoneal (TAPP)repair.Aim: To compare the laparoscopic TAPP and TEP repair of inguinal hernia in RIH.Patients and Methods: This was a prospective randomized study planned for patients diagnosed with RIH. The studypopulation was divided into two groups; group (1) included patients who had the TAPP approach, while group (2) includedpatients who had TEP approach. The patients were evaluated for postsurgical adverse events such as postoperative pain,recurrence, infection, seromas, and hematomas.Results: There were significant differences recorded among both groups as regards operative time and postoperativepains, which were significantly increased in the TAPP group compared to TEP group. No significant difference wasrecorded between the groups regarding operative complications and recurrence rate.Conclusion: In the context of RIH, both TEP and TAPP repair seem to be efficient approaches with regard to lowrecurrence rate and minimal complications. However, TEP was associated with minimal pain and short OT.