Our Summary

This study compares two techniques for performing laparoscopic hernia repair - transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP). The researchers looked at all patients who had this type of surgery at a large UK hospital between 2015 and 2020. They found that both techniques had similar success rates, complication rates, and recurrence rates. However, patients who had the TAPP procedure had a longer hospital stay and more instances of fluid collection (seroma) after surgery. The study suggests that the choice of technique should be based on the surgeon’s skill and experience, as the outcomes of the two procedures are largely similar.

FAQs

  1. What are the two techniques for performing laparoscopic hernia repair studied in this research?
  2. How did the success and complication rates between TAPP and TEP procedures compare in the study?
  3. What factors should be considered when choosing between a TAPP or TEP procedure for laparoscopic hernia repair?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic hernia repair is to follow post-operative instructions carefully to minimize the risk of complications such as seroma formation. This may include avoiding heavy lifting, taking prescribed medications as directed, and attending follow-up appointments with your surgeon. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support the healing process and prevent future hernias.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair are those who have inguinal hernias that are causing symptoms such as pain, discomfort, or difficulty with daily activities. Additionally, patients who are looking for a minimally invasive surgical option with faster recovery times and less post-operative pain are also good candidates for this procedure. Patients with certain medical conditions or anatomical factors may not be suitable for laparoscopic hernia repair and may require a traditional open surgery approach. Ultimately, the decision to undergo laparoscopic hernia repair should be made in consultation with a surgeon who can evaluate the individual patient’s specific circumstances and recommend the best treatment option.

Timeline

Before laparoscopic hernia repair:

  1. Patient consults with a surgeon to discuss the need for surgery and the different options available.
  2. Pre-operative testing and evaluation are conducted to ensure the patient is a suitable candidate for laparoscopic hernia repair.
  3. Patient receives instructions on pre-operative preparations, such as fasting before surgery and stopping certain medications.
  4. Surgery date is scheduled and patient arrives at the hospital or surgical center on the day of the procedure.

During laparoscopic hernia repair:

  1. Patient is given anesthesia to put them to sleep and ensure they do not feel any pain during the surgery.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope (thin tube with a camera) to view the hernia and surrounding tissue.
  3. Hernia is repaired using surgical instruments inserted through additional small incisions.
  4. Procedure typically takes around 30-60 minutes to complete.

After laparoscopic hernia repair:

  1. Patient is monitored in the recovery room until they wake up from anesthesia and are stable.
  2. Patient may experience some pain, swelling, and bruising at the incision sites, which can be managed with pain medication.
  3. Patient is usually able to go home the same day or the day after surgery, depending on their recovery progress.
  4. Patient is advised to avoid strenuous activities and heavy lifting for a few weeks to allow the surgical site to heal properly.
  5. Follow-up appointments are scheduled to monitor the patient’s recovery and address any concerns or complications that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic hernia repair?
  2. How long is the recovery period for this type of surgery?
  3. Will I need to stay in the hospital after the procedure, and for how long?
  4. What type of anesthesia will be used during the surgery?
  5. How experienced are you in performing laparoscopic hernia repair, and how many of these procedures have you done?
  6. What is the success rate of this procedure for my specific type of hernia?
  7. What is the likelihood of the hernia recurring after surgery?
  8. Will I need to follow any special dietary restrictions or activity limitations after the surgery?
  9. How long will it take for me to return to normal activities and work?
  10. Are there any specific post-operative symptoms or complications I should watch out for?

Reference

Authors: Ortenzi M, Williams S, Solanki N, Guerrieri M, Haji A. Journal: Minerva Chir. 2020 Oct;75(5):279-285. doi: 10.23736/S0026-4733.20.08518-1. PMID: 33210522