Tapp technique performed by young hands. Reproducing the results of the lichtenstein procedure for symptomatic primary unilateral inguinal hernia

Abstract

Background: Inguinal hernia repair is one of the most common procedures in general surgery. Each year, 20 million surgeries for inguinal hernia repaired are performed; the most common techniques used are the Lichtenstein procedure and the transabdominal preperitoneal (TAPP) laparoscopic approach.
Objective: The aim of the present study is to evaluate the outcomes of the TAPP approach performed by residents and young surgeons in training in a university center. TAPP was compared with the Lichtenstein and the outcomes at 30 days were compared.
The variables considered were complications, postoperative pain, length of hospital stay and procedure-related costs. The long-term variables analyzed were recurrence and chronic pain.
Material and methods: We conducted an observational study comparing two surgical techniques, using prospectively acquired information from the database of our department. The cohort was made up of 80 patients undergoing inguinal hernia repair in two university-based hospitals in Montevideo, Uruguay (Hospital de Clínicas and Hospital Español), between May 2015 and May 2019. The patients were divided into two groups: Lichtenstein procedure (group 1) and TAPP procedure (group 2).
Results: There were no significant differences in length of hospital stay and postoperative complications. One patient in the Lichtenstein group presented hernia recurrence. Mean operative time was 20 minutes longer with laparoscopic hernia repair, and the cost of the materials was higher. Postoperative pain at 24 hours was greater in the TAPP group, but was similar at 48 hours, 7 days, one month, three months and six months in both groups.