Comparison of Early Results of Laparoscopic Transabdominal Preperitoneal and Total Extraperitoneal Repair in Recurrent Inguinal Hernia.

Abstract

Background: The optimal surgical approach for recurrent inguinal hernia remains controversial. Among the commonly used laparoscopic techniques, transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) repairs are frequently performed, yet data comparing their short-term outcomes in recurrent cases are limited. This study aimed to compare early clinical outcomes of TAPP versus TEP in recurrent inguinal hernia repair. Methods: We retrospectively analyzed 48 patients who underwent laparoscopic surgery for recurrent inguinal hernia between January 2022 and April 2024 at two centers. Patients were assigned to TEP (n = 27) or TAPP (n = 21) groups based on surgeon preference. Demographics, intraoperative variables, and postoperative outcomes including recurrence, complications, visual analogue pain scores (visual analogue scale [VAS]), analgesic requirement, urinary retention, seroma formation, and testicular complications, were assessed. Results: Baseline characteristics were comparable except for age, which was significantly lower in the TAPP group (47.5 ± 14.1 versus 60.3 ± 10.2; P < .001). No significant differences were observed in operative time, VAS scores, or hospital stay. Although intraoperative bleeding, urinary retention, and seroma were more frequent in the TAPP group, these did not reach statistical significance. No conversions to open surgery occurred in the TEP group, while one was noted in the TAPP group. During a median follow-up of 22 months for TEP and 16 months for TAPP, a single recurrence was observed in the TAPP group (4.8%). Rates of chronic pain were similar between groups. Conclusion: Both TAPP and TEP are safe and effective for recurrent inguinal hernia repair, with low complication and recurrence rates. No clear superiority was demonstrated. Surgical technique should be selected based on individual patient and anatomical factors. Further randomized prospective studies are needed to better define the optimal approach in recurrent cases.