LAPAROSCOPIC HERNIOPLASTY - TAPP VS TEP

This study compares the results of two laparoscopic hernioplasties: th e transabdominal preperitoneal (TAPP) and the totally extraperitoneal (TEP). Over a 43-month period 1,115 laparoscopic hernioplasties, 733 T APP and 382 TEP, were performed in 866 patients. There were II major c omplications in the TAPP group (2 recurrences, 6 trocar hernias, 1 sma ll-bowel obstruction, 1 trocar, and 1 dissection injury of the small b owel) compared to 1 recurrence and no intraperitoneal complications in the TEP group. Five TEP procedures required conversion to the TAPP ap proach, resulting in one umbilical hernia. The median time to return t o work did not vary with the approach, but was prolonged in patients c ompensated for time off, 16 vs 8 days for noncompensated patients. Res ults suggested that both techniques shortened recovery and eliminated most early failures, but the totally extraperitoneal approach reduced the potential for intraperitoneal complications and may be the procedu re of choice in most situations.