TEP or TAPP for recurrent inguinal hernia repair-register-based comparison of the outcome.
INTRODUCTION
The guidelines of the international hernia societies recommend laparo-endoscopic inguinal hernia repair for recurrent hernias after open primary repair. To date, no randomized trials have been conducted to compare the TEP vs TAPP outcome for recurrent inguinal hernia repair. A Swiss registry study identified only minor differences between the two techniques, thus suggesting the equivalence of the two procedures.


MATERIALS AND METHODS
Between September 1, 2009 and August 31, 2013 data were entered into the Herniamed Registry on a total of 2246 patients with recurrent inguinal hernia repair following previous open primary operation in either TAPP (n = 1,464) or TEP technique (n = 782).


RESULTS
Univariable and multivariable analysis did not find any significant difference between TEP and TAPP with regard to the intraoperative complications, complication-related reoperations, re-recurrences, pain at rest, pain on exertion, or chronic pain requiring treatment. The only difference identified was a significantly higher postoperative seroma rate after TAPP, which was influenced by the surgical technique, previous open primary operation and EHS-classification medial and responded to conservative treatment.


CONCLUSION
TEP and TAPP are equivalent surgical techniques for recurrent inguinal hernia repair following previous open primary operation. The choice of technique should be tailored to the surgeon's expertise.
['Köckerling|F|F|', 'Bittner|R|R|', 'Kuthe|A|A|', 'Hukauf|M|M|', 'Mayer|F|F|', 'Fortelny|R|R|', 'Schug-Pass|C|C|']
D000328:Adult D004724:Endoscopy D006552:Hernia, Inguinal D006801:Humans D007431:Intraoperative Complications D008297:Male D008875:Middle Aged D010146:Pain D059408:Pain Management D011183:Postoperative Complications D011446:Prospective Studies D012008:Recurrence D012042:Registries D012086:Reoperation D049291:Seroma D013526:Surgical Mesh D013557:Switzerland D016896:Treatment Outcome
TEP TAPP Recurrent inguinal hernia Hernia Seroma