Publication:

Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

Background As the laparoscopic method is becoming a popular choice of repair, the need to evaluate its impact on the patient’s quality of life (QOL) is also warranted. This study was undertaken to compare post operative QOL in patients undergoing Totally Extraperitoneal (TEP) and Transabdominal preperitoneal (TAPP) repair for indirect inguinal hernia.

Methods This prospective observational study was conducted in the Department of General Surgery at VMMC and Safdarjung Hospital, from June 2016 to March 2018. Patients with uncomplicated indirect inguinal hernia were included in the study after obtaining their informed consent. Post-operative QOL was evaluated using EuraHS-QOL scale at 24 hours and 1, 3 and 6 months after the surgery.

Results A total of sixty patients were enrolled-30 in TEP group and 30 in TAPP group. There was no statistical significant difference in scores at 24 hours follow-up except cosmetic discomfort domain, with higher scores in TAPP (p-value=0.014). Statistical significant difference was present at 1 month follow up with higher scores in TAPP (p-value=0.011). At 3 and 6 months, no statistical difference was found in the scores.

Conclusions Present study demonstrates a significant advantage of TEP over TAPP up to 1-month follow-up, in terms of post-operative QOL. Choosing a superior laparoscopic method between TEP and TAPP requires high powered RCTs with long term follow up to assess the technical advantages and post-operative complications along with post-operative quality of life in patients.