Clinical analysis of laparoscopic transabdominal preperitoneal hernioplasty (TAPP) for incarcerated inguinal hernia

This study explores the safety and feasibility of laparoscopic transabdominal preperitoneal hernioplasty (TAPP) in treating incarcerated inguinal hernia. Clinical data of 65 patients with incarcerated inguinal hernias treated in the Department of General Surgery, Affiliated Hospital of Hebei University from September 2019 to December 2023 were retrospectively analyzed for clinical therapeutic effects and complications. Among the 65 patients, there were 43 cases in the TAPP group, with incarcerated contents including 28 cases of intestines, 14 cases of omentum, and 1 case of mixed; hernia types included 38 cases of indirect hernias, 2 cases of direct hernias, and 3 cases of femoral hernias; the open group had 22 cases, with incarcerated contents including 7 cases of intestines and 15 cases of omentum, and hernia types included 18 cases of indirect hernias and 4 cases of femoral hernias. Following Bonferroni correction for multiple comparisons across 7 primary outcomes (adjusted α = 0.007), statistically significant differences between groups persisted for: operative time (P < .001), length of hospital stay (P = .007), intraoperative blood loss (P = .014), postoperative day 1 Visual Analog Scale (VAS) pain score (P = .014), and hospitalization costs (Mann-Whitney U = -6.142, P = .007). In contrast, differences in postoperative day 2 VAS pain score (P = .287) and time to first flatus (P = .147) were not statistically significant after adjustment. The difference between the complications in the TAPP group and the open group (P > .05) was not statistically significant. In emergency surgery for incarcerated hernias, the TAPP procedure, compared to the Lichtenstein procedure, can significantly reduce postoperative pain and shorten hospital stay without increasing surgical complications, making it a safe and feasible surgical option.