Hernia : the journal of hernias and abdominal wall surgery
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Review Multicenter Study Comparative Study
Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review.
The choice of approach to the laparoscopic repair of inguinal hernia is controversial. There is a scarcity of data comparing the laparoscopic transabdominal preperitoneal (TAPP) approach with the laparoscopic totally extraperitoneal (TEP) approach, and questions remain about their relative merits and risks. ⋯ There is insufficient data to allow conclusions to be drawn about the relative effectiveness of TEP compared with TAPP. Efforts should be made to start and complete adequately-powered randomised controlled trials (RCTs), which compare the different methods of laparoscopic repair.
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Incarcerated inguinal hernias have been considered a relative contraindication for endoscopic surgery, as its efficacy and safety is as yet unproven. With more experience and improved techniques, management of incarcerated hernias by the endoscopic approach has become possible with decreased patient discomfort and acceptable results. ⋯ With the help of modifications in operating technique, Endoscopic Totally Extraperitoneal repair is feasible and effective in patients with incarcerated inguinal hernias and encompasses the advantages of endoscopic procedures.