Publication:

Safety, complications and predictors of outcomes in extended totally extraperitoneal inguinal hernia repair: a prospective observational study

Background Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide. The extended totally extraperitoneal (eTEP) approach has gained increasing acceptance because of its improved visualization, enhanced ergonomics, and reduced postoperative morbidity. However, prospective data regarding its safety profile, postoperative complications, recurrence, and factors influencing surgical outcomes remain limited.

Methods A prospective observational study was conducted among 60 adult patients undergoing eTEP inguinal hernia repair at a tertiary care center. Demographic characteristics, operative details, intraoperative events, postoperative complications, and recurrence were prospectively recorded. Patients were followed at 1, 3, and 6 months after surgery. Data were analyzed using descriptive and inferential statistics, with a p-value <0.05 considered statistically significant.

Results The mean age of the study population was 52 ± 10 years, and 75% of patients were male. The mean operative time was 75 ± 15 minutes. Intraoperative complications were uncommon, with 95% of patients experiencing no adverse events. Postoperative complications occurred in 15% of patients, with seroma being the most frequent (8.3%), followed by hematoma (3.3%), surgical site infection (1.7%), and foreign body sensation (1.7%). Recurrence was observed in 3.3% of patients at 3 months and 5.0% at 6 months. Patients aged ≥50 years, those with higher body mass index, and those with bilateral hernias had significantly longer operative times, higher postoperative pain scores, and longer hospital stays (p <0.05).

Conclusions The eTEP technique is a safe and effective minimally invasive approach for inguinal hernia repair, demonstrating low intraoperative and postoperative complication rates with minimal early recurrence. Advanced age, higher body mass index, and bilateral hernia are associated with less favorable perioperative outcomes and should be considered during preoperative assessment and surgical planning.