A comparative study on optical trocar entry vs. balloon trocar entry in laparoscopic eTEP inguinal hernia repair - a randomised control trial.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-04-08 DOI:10.1007/s10029-025-03329-4

Tharun Ganapathy Chitrambalam, K S Suryaa Harshan, Ramprakash Ramanathan, Muthuvignesh Vijayakumar, Amit Salim Gilani

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引用次数: 0

Abstract

Background: The enhanced Totally Extra-Peritoneal (eTEP) technique is a novel minimally invasive approach to inguinal hernia repair that involves entry into the retro-rectus space and dissection of preperitoneal spaces. Aim of this study is to compare two methods for creating the preperitoneal space: optical trocar dissection (Group A) and balloon trocar dissection (Group B).

Materials and methods: A prospective, single-blinded, interventional study was conducted with 116 patients, randomized into two groups (58 in each group) undergoing eTEP inguinal hernia repair at SRM Medical College Hospital, India. Key outcomes assessed included the duration of surgery, intraoperative complications, postoperative pain, and postoperative occurences such as seroma and hematoma.

Results: The study found that balloon trocar dissection resulted in significantly shorter surgery duration (mean 62 min vs. 75 min, p<0.001) and quicker preperitoneal space creation (13 min vs. 19 min, p<0.0001). Balloon dissection also showed fewer incidents of peritoneal breaches (0% vs. 10.34%, p<0.002), lower postoperative pain scores, and a lower incidence of seroma and hematoma formation (1.72% vs. 17.24%, p<0.004).

Conclusion: These findings suggest that balloon trocar dissection is a safer, more efficient method for eTEP inguinal hernia repair, offering a smoother learning curve for surgeons, especially during the early stages of the procedure.

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腹腔镜下eTEP腹股沟疝修补术中光学套管针置入与气囊套管针置入的比较研究——一项随机对照试验。

背景：增强全腹膜外（eTEP）技术是一种新型的微创腹股沟疝修补方法，涉及进入后直肌间隙并剥离腹膜前间隙。本研究的目的是比较两种创造腹膜前间隙的方法：光学套管针分离（A组）和球囊套管针分离（B组）。材料和方法：在印度SRM医学院医院进行了一项前瞻性、单盲、介入性研究，116例患者随机分为两组（每组58例）接受eTEP腹股沟疝修补术。评估的主要结局包括手术持续时间、术中并发症、术后疼痛和术后发生的血肿和血肿。结果：研究发现，气囊套管针分离术可显著缩短手术时间（平均62分钟vs 75分钟）。结论：这些发现表明，气囊套管针分离术是一种更安全、更有效的eTEP腹股沟疝修复方法，为外科医生提供了更顺畅的学习曲线，特别是在手术的早期阶段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.