Publication:

Intraoperative and postoperative complications in transabdominal preperitoneal versus totally extraperitoneal laparoscopic inguinal hernia repair: a prospective randomized controlled trial

Background Laparoscopic inguinal hernia repair has gained widespread acceptance due to reduced postoperative pain, improved recovery, and favorable cosmetic outcomes. Among laparoscopic approaches, transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair are the most commonly employed techniques. However, comparative evidence regarding intraoperative and postoperative complication profiles remains variable.

Methods This prospective randomized controlled trial was conducted in the Department of General Surgery at Mahatma Gandhi Medical College and Hospital from April 2024 to September 2025. Sixty patients with inguinal hernia were randomized into TAPP (n=30) and TEP (n=30) groups. Postoperative pain was assessed using the visual analogue scale (VAS), and patients were followed for six months.

Results The mean operative time was significantly shorter in the TAPP group (60.97±11.41 minutes) compared to the TEP group (69.37±11.25 minutes; p=0.006). Early postoperative pain at 6 and 12 hours was significantly lower in the TEP group (p<0.05). Incidence of edema, urinary retention, hematoma, chronic pain, and recovery outcomes were comparable.

Conclusions Both TAPP and TEP are safe and effective laparoscopic techniques with comparable complication profiles. TAPP offers shorter operative time, whereas TEP provides reduced immediate postoperative pain. Long-term outcomes are equivalent.