TEP or TAPP for recurrent inguinal hernia repair-register-based comparison of the outcome.
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.



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).



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.



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.
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, D-13585, Berlin, Germany. ferdinand.koeckerling@vivantes.de.
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Köckerling
Winghofer Medicum, Hernia Center, Winghofer Strasse 42, D-72108, Rottenburg am Neckar, Germany.
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Bittner
Department of General and Visceral Surgery, German Red Cross Hospital, Lützerodestrasse 1, D-30161, Hanover, Germany.
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Kuthe
StatConsult GmbH,, Halberstädter Strasse 40 a, D-39112, Magdeburg, Germany.
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Hukauf
Department of Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria.
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Mayer
Department of General-, Visceral- and Oncologic Surgery, Wilhelminen Hospital, Montleartstrasse 37, 1160, Vienna, Austria.
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Fortelny
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, D-13585, Berlin, Germany.
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Schug-Pass
D000328:Adult; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D059408:Pain Management; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012086:Reoperation; D049291:Seroma / Q000453:epidemiology / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects*; D013557:Switzerland; D016896:Treatment Outcome
Hernia; Recurrent inguinal hernia; Seroma; TAPP; TEP