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Volume 13 Issue 12 (December) 2024

Original Articles

A Comparative Evaluation of TEP (Standard Totally Extraperitoneal) and e TEP (Extended Totally Extraperitoneal) repair of inguinal hernias in tertiary care center of Central India
Dr. Suchitra Biswas, Dr. Navneet Mishra, Dr. Rishabh Soni

Background: Minimally invasive technique for inguinal hernia repair has been gaining popularity in the modern era. This study discusses our experience with the extended view totally extraperitoneal repair (eTEP)and its advantages which significantly expands the dissection plan over standard total extraperitoneal repair (TEP) of inguinal hernias. Materials & methods: A prospective study was carried out for 60 patientsof more than 18 years of age, diagnosed with unilateral or bilateral inguinal hernias, medically fit to undergo the procedure were included into the study,one year from may 2022 to may 2023 by a single surgeon and his team. 30 patients underwent standard TEPand rest 30 underwent extended TEP.Patients were randomly assigned to each group. Based on ease of surgeon to perform the procedure,intraoperative and postoperative data from each one of the procedures was obtained and analysed.All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis using SPSS software. Results: We performed TEPusing three midline ports and eTEP frommay 2022 to may 2023. Out of them, 73.3% were unilateral inguinal hernia and 26.6% were bilateral inguinal herniaThe mean operative time in TEP repair using three midline ports was 45 minutes and 68 minutes for unilateral and bilateral inguinal hernias respectively and that in eTEP repair was 60 minutes and 84 minutes respectively for unilateral and bilateral(P = 0.4321). Conversion to TAPP was seen in 4 patients in TEP group. There was no significant difference between the two procedures in post operative parameters such as seroma/ hematoma formation , port site SSI, Mesh infection or post operative pain score. However in eTEP there is relatively easy creation of a large preperitoneal space which results in more ergonomic instrument manipulation. Conclusion: Comparision of both the techniques showed extended TEP as a better alternative to standard TEP in terms of technical ease to the surgeon. In experienced hands both TEP and eTEP provides similar results but due to better ergonomics of eTEP it is better adapted by the surgeons as a procedure of choice for inguinal hernia repair.

 
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