OBJECTIVE: To compare the Transabdominal preperitoneal (TAPP) vs. Totally extra peritoneal (TEP) techniques of laparoscopic inguinal. performance of laparoscopic inguinal repair, whether via the totally extraperitoneal (TEP) approach or via the transabdominal preperitoneal. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair - A systematic review and meta-analysis.


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As for early postoperative complications, no patient had a scrotal hematoma that was drained transabdominal preperitoneal local anesthesia. Five patients were given a diagnosis of scrotal seroma developing at the site of operation.

Two different laparoscopic techniques for repairing a hernia in the groin | Cochrane

There were no cases of operation-related orchitis, testicle edema, or trocar site infection during follow-up.

Groin pain at transabdominal preperitoneal weeks was markedly lower than at postoperative 3 months. All patients suffering from postoperative pain with movement reported that this gradually reduced over transabdominal preperitoneal.


No severe chronic pain was observed at postoperative 6 transabdominal preperitoneal. The median follow-up was 32 months range, 18—60 months. Early recurrence was clinically diagnosed 3 weeks after surgery in 1 patient.

This patient immediately underwent open anterior hernia repair in our hospital. Discussion We designed this study to assess the feasibility and safety of Transabdominal preperitoneal hernia repair using memory-ring Polysoft mesh.

Our results showed a low incidence of postoperative events.

The technique of TAPP hernia repair using Polysoft mesh is feasible even for the repair of large, complex hernias, including pantaloon hernias and recurrent hernias, without any special difficulties. Prosthetic mesh is now routinely used for inguinal hernia repair [ 16 ]. The low recurrence rates associated with mesh repair have shifted transabdominal preperitoneal attention of surgeons from recurrence to chronic pain after surgery.

The chronic pain after onlay over the floor of the inguinal canal mesh placement has been attributed to fibrosis around the mesh.

The fibrosis induced by the placement of onlay mesh at sites transversed by major inguinal sensory nerves ilioinguinal, transabdominal preperitoneal, and genital branch of genitofemoral nerves causes pain due to strong fixation of the mesh to the region around the inguinal canal [ 7 ].

Chronic pain has been classified into two types: The continuous inflammation around the mesh may lead to nerve damage. The mesh, as a foreign body, induces a dense fibroblastic response that stimulates the formation of severe scar tissue.

The increased size of the inflammatory area caused by the mesh may promote nerve adherence or abrasion that accounts for an increased risk of neuropathic pain.

Placement of the mesh in the preperitoneal space offers the advantage of avoiding inflammatory response leading to the formation of transabdominal preperitoneal scar tissue in the region of the inguinal sensory nerves and the spermatic cord [ 5 — 9 ].

This preperitoneal space is the same site used for laparoscopic approaches.


Consequently, placement of the mesh in the preperitoneal space might have the advantage of decreasing postoperative chronic pain in both anterior and laparoscopic inguinal repair.

Laparoscopic hernia repair using a Polysoft mesh offers several advantages over the use of a conventional flat mesh without a memory-ring.

First, resident surgeons often find it transabdominal preperitoneal to spread a conventional flat mesh transabdominal preperitoneal laparoscopic surgery. A Polysoft mesh with a memory-ring is easier to spread completely without mesh deformity than a conventional flat mesh.

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Another advantage is that mesh migration is unlikely even if fixation of the mesh to the neighboring tissues is minimal, because a Polysoft mesh maintains its configuration. Transabdominal Preperitoneal TAPP versus Lichtenstein operation for primary inguinal hernia repair - A systematic review and meta-analysis of randomized controlled trials.

Transabdominal Preperitoneal TAPP and Lichtenstein operation are established methods for inguinal transabdominal preperitoneal repair in clinical practice.

Therefore, we firstly recommended TAPP for laparoscopic hernia repair, especially for nonexpert surgeons. Further choices would be made according to the specific clinical characteristics of patients and surgeons.

  • Two different laparoscopic techniques for repairing a hernia in the groin
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