Estrada GRA, León CMR, Heredia RM, Guerrero MGA, Flores SJP, Anthón MFJ, De la Cruz RL

Language: Spanish
References: 18
Page: 7-12
PDF size: 227.06 Kb.

ABSTRACT

Introduction: Less than 5% of Mexican surgeons perform some kind of videoendoscopic surgery for hernias, of which TAPP and TEP are the most widely accepted techniques globally. There are few reports worldwide using mini-instruments and none comparing TEP to TAPP. Material and methods: This is a prospective, randomized study comparing both techniques with the same group of surgeons in two different hospital institutions; we evaluated trans- and postoperative variables, postoperative pain and short- and mid-term follow-up. Low-friction 3-mm ports were used, all patients were under sedation and local anesthesia. Results: Two hundred inguinal videoendoscopic hernia repairs were performed in 152 patients over a period of two years. The overall age average was 49 years; 82.8% were male and 17.2% female. We randomly divided patients into two groups: 1) TAPP, 92 people, and 2) TEP, 60. The surgical time for group 1 was 59 ± 17 minutes, while that of group 2 was 42 ± 9. Within the transoperative complications, bleeding was the most common in both techniques. With regard to postoperative pain according to the analog visual scale, VAS at 12 hours in the TAPP group was 3.5 ± 0.9, vs. 3.4 ± 1.1 in the TEP group. No surgery was converted from mini-laparoscopy to conventional laparoscopic surgery or open surgery. Long-term follow-up has not shown chronic pain. Two recurrences were reported, one from each group. Conclusions: The reported findings demonstrate that both techniques are safe, feasible and reproducible without significant difference between them in relation to operative time, trans- and postsurgical complications, pain, and recurrence. The use of mini-instruments gives the surgeon greater precision in the manipulation and dissection of tissues, thus promoting a lower risk of unnoticed injuries and transoperative bleeding.

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