Three-Year Single-Center Retrospective Comparison of Total Extraperitoneal Versus Transabdominal Preperitoneal Approach Laparoscopic Groin Hernia Repair: Postoperative Complications and Operative Performance

AIM: This single-center study aimed to evaluate the postoperative complications and operative performance of the total extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) techniques used in laparoscopic groin hernia repair.METHODS: A total of 511 patients who underwent laparoscopic groin hernia repair between January 2022 and January 2025 were screened for eligibility, and 116 patients who did not meet the eligibility criteria were excluded. Patients were divided into the TEP (n = 291) and TAPP (n = 104) groups. The primary endpoint was the comparison of postoperative complication rates between the TEP and TAPP groups according to the Clavien–Dindo classification. The secondary endpoint was defined as a comparison of the operative time between the groups.RESULTS: Significant differences in terms of age and American Society of Anesthesiologists (ASA) score were observed between the groups (p < 0.001 and p = 0.003, respectively), whereas no significant differences were found regarding sex, prior open hernia repair (recurrent hernia), preoperative symptom type, or hernia localization (p = 0.172, p = 0.059, p = 0.726, and p = 0.062, respectively). The distribution of hernia types was comparable between the groups (p = 0.957), whereas the operative time was significantly shorter in the TEP group (p < 0.001). The Clavien–Dindo classification indicated no significant differences in postoperative complication rates between the groups (p = 0.545). Grade ≥ IIIA complications were observed at low rates for both groups, and all grade IIIB events corresponded to recurrence cases. All recurrences were reoperated using open surgical repair.CONCLUSIONS: In our single-center experience, TEP and TAPP techniques demonstrated similar safety profiles in terms of postoperative complications. Operative time was shorter with the TEP technique, whereas complication rates were low in both approaches. Multicenter prospective studies are required to validate these findings and enhance generalizability.