Comparison of Short-Term Results of Total Extraperitoneal Repair Using Balloon Dissection with Mesh Fixation Versus Telescopic Dissection Without Mesh Fixation.

Abstract

Background: Total extraperitoneal (TEP) hernia repair is a minimally invasive method for the treatment of inguinal hernia. In this study, one group with balloon dissection and mesh fixation was compared with another group that underwent telescopic dissection without mesh fixation. This study aims to compare both methods in terms of effectiveness, complications, pain scores, and clinical outcomes. Material and methods: This study is a retrospective evaluation of prospectively acquired data from patients in a single-center setting. Patients were divided into two groups: Group 1, who underwent balloon dissection with mesh fixation, and Group 2, who underwent direct telescopic dissection without mesh fixation. All operations were performed by the same surgical team. Predefined data for both groups were compared statistically. Results: Among the 115 patients, 66 (57.4%) were in Group 1 and 49 (42.6%) in Group 2. No significant difference was found between demographic characteristics and clinical features for two groups. Surgical times for unilateral and bilateral repairs were similar between the groups. Hospital stay duration was also comparable. The conversion rates to transabdominal preperitoneal were 4.5% in Group 1 and 8.2% in Group 2. Postoperative complications were similar between the groups. However, significant differences were found in pain scores, with Group 1 experiencing higher pain levels on the first day, after 1 week, and after 6 months compared to Group 2. Conclusion: Both balloon dissection with mesh fixation and direct telescopic dissection without mesh fixation are safe and effective techniques for TEP hernia repair with similar short-term outcomes. However, balloon dissection and mesh fixation may result in higher postoperative pain levels and incur higher costs. The choice of technique should be guided by available resources, surgeon experience, and patient-specific factors. Further studies are needed to evaluate the long-term outcomes and cost-effectiveness of both approaches.