A Comparative Study of Totally Extrapritoneal (TEP) and Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Objective- To compare Totally Extra Peritoneal (TEP) repair with Trans Abdominal Pre Peritoneal (TAPP) repair of inguinal hernia. To compare the operative time, technique, intraoperatve and postoperative complications of TEP and TAPP repair of uncomplicated inguinal hernia. Material And Methods: The study is prospective & randomized clinical trial in nature. A sample of size 60 was studied in the DEPARTMENT OF SURGERY, at the SUBHARTI MEDICAL COLLEGE ,MEERUT.The sample size was calculated by using the formula n=4σ2 /L2 . where σ 2 =variance of sample observations and L2 = least permissible error. In our study, the variance was maintained 1.36 & least permissible error was fixed at .02 (2%) . The Patients, who underwent LAPAROSCOPIC REPAIR OF GROIN HERNIA between 1st May, 2016 and 31st March, 2018 were randomized to either TEP or TAPP repairs. The two types of surgical methods were analyzed by making the frequency tables of 60 patients. The significant difference b/w TEP & TAPP surgeries was observed by un-paired/student’s “t” test at .01 level of significance.The p- value less than .01 was considered as significant .i.e.P<.01.Further, all the statistical analysis was done by using S.P.S.S. software 23.0 version. Result- In this study out of 60 patients ,37 patients were treated by TAPP surgery and 23 patients were treated by TEP. Out of which all patients are male and all are unilateral hernia.Out of 60 patients study shown, 23 patients was of TEP. study showed the duration of stay of hospital in both TEP and TAPP is 3 to 4 days.In our study the cost of TEP and TAPP was 10200 and 11050 respectiely. There was significantly mild pain following TEPP repair; however,the pain was comparable in both TEP and TAPP. Preoperative pain and immediate postoperative pain had significant correlation with pain. Significant improvement from preoperative to postoperative quality of life was seen in both TEP and TAPP repairs, but there was no difference between TEP and TAPP in postoperative period. Time to return to normal activity also was similar between the two group. In our study there is no vas deferens injury ,no blader injury ,no bleeding and no bowel Injury. Conclusion— The both type of surgeries are safe. However in TEP and TAPP surgeries , cost factor is less for TAPP and operative time increases for TEP surgery .The TEP and TAPP techniques of laparoscopic repair of inguinal hernia have comparable long-term outcomes in terms of incidence of chronic groin pain, quality of life, and resumption of normal activities. However,in many study TEP surgery was associated with significantly higher incidence of early post-operative pain having longer operative time and cord edema, whereas TAPP was associated with a significant higher incidence of SEROMA formation. But in this study no SEROMA formation and pain was not significant. The cost was comparable between the two types of surgeries.
Authors and Affiliations
Dr Kumar Dhanesh, Dr Srivastava Antriksh, Dr Agrawal Vijay, Dr MaheshwarI M. K. , Dr Parashar Devesh
Keywords
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- EP ID EP446234
- DOI 10.9790/0853-1801180107.
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