Surgeons' Approach to Intraoperative Complications in Total Extraperitoneal (TEP) Hernia Repair.

Background and objectives: This study aimed to determine the frequency of laparoscopic inguinal hernia repair (LIHR) and how surgeons managed complications such as intraoperative bleeding, organ damage, and peritoneal injury that may develop during this procedure.

Methods: The data for the study were collected through an electronic survey created using Google Forms and sent using WhatsApp in May 2024.

Results: The study included 220 of 250 surgeons (88%) working in 25 healthcare centers located in different regions where the survey was distributed. Fourteen respondents with missing data were excluded from the study. The mean age of the remaining 206 participants was 39.6 (27-69) years. The rate of surgeons using laparoscopic techniques in inguinal hernia surgery was 89.3%. The method most preferred by the surgeons performing LIHR was total extraperitoneal (TEP) repair (60.9%), followed by transabdominal preperitoneal (TAPP) repair (39.1%). The surgeons preferred open procedures in patients with a history of lower abdominal surgery, those with scrotal hernia, and elderly patients. Additionally, in cases of intraoperative complications that developed at different stages of TEP, it was observed that participants mostly convert to the TAPP technique (43.5-46%), and in some cases, almost all participants continued the procedure with the same technique, i.e., TEP repair (94.6%).

Conclusion: This study revealed that surgeons preferred open procedures in some specific patient groups, but they mostly preferred LIHR in the remaining cases. Young surgeons, in particular, seem more inclined to employ laparoscopic methods. In cases of intraoperative complications, most surgeons chose to continue with laparoscopic techniques.