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Laparoscopic Totally Extraperitoneal (TEP) Inguinal Hernia Repair

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Abstract

Totally extraperitoneal hernia repair (TEP) is a relatively new technique of repairing inguinal hernias where the dissection and repair are carried out without violating the peritoneal cavity. McKernan and Law first introduced totally extraperitoneal hernia repair in 1993 (McKernan and Laws, Surg Endosc 7(1):26–28, 1993). They reported 51 cases, of which, 11 were recurrent and 12 were bilateral. The procedure has since been refined, especially with advancements is surgical technology and training.

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References

  1. McKernan JB, Laws HL. Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endosc. 1993;7(1):26–8.

    Article  CAS  PubMed  Google Scholar 

  2. Bittner R, et al. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc. 2011;25(9):2773–843.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc. 2009;23(3):482–6.

    Article  PubMed  Google Scholar 

  4. Bittner R, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015;29(2):289–321.

    Article  CAS  PubMed  Google Scholar 

  5. Bittner R, et al. One-year results of a prospective, randomised clinical trial comparing four meshes in laparoscopic inguinal hernia repair (TAPP). Hernia. 2011;15(5):503–10.

    Article  CAS  PubMed  Google Scholar 

  6. Eklund A, et al. Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg. 2006;93(9):1060–8.

    Article  CAS  PubMed  Google Scholar 

  7. Choi YY, Kim Z, Hur KY. Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia. Can J Surg. 2012;55(1):33–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Park BS, et al. Factors influencing on difficulty with laparoscopic total extraperitoneal repair according to learning period. Ann Surg Treat Res. 2014;87(4):203–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Poelman MM, et al. EAES Consensus Development Conference on endoscopic repair of groin hernias. Surg Endosc. 2013;27(10):3505–19.

    Article  CAS  PubMed  Google Scholar 

  10. Kockerling F, et al. Do we need antibiotic prophylaxis in endoscopic inguinal hernia repair? Results of the Herniamed registry. Surg Endosc. 2015;29(12):3741–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Mazaki T, et al. Antibiotic prophylaxis for the prevention of surgical site infection after tension-free hernia repair: a Bayesian and frequentist meta-analysis. J Am Coll Surg. 2013;217(5):788–801. e1–4.

    Article  PubMed  Google Scholar 

  12. Yin Y, et al. Antibiotic prophylaxis in patients undergoing open mesh repair of inguinal hernia: a meta-analysis. Am Surg. 2012;78(3):359–65.

    PubMed  Google Scholar 

  13. Sanchez-Manuel FJ, Lozano-Garcia J, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev. 2012;2, CD003769.

    Google Scholar 

  14. Li JF, et al. Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty. Can J Surg. 2012;55(1):27–32.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Schwetling R, Barlehner E. Is there an indication for general perioperative antibiotic prophylaxis in laparoscopic plastic hernia repair with implantation of alloplastic tissue? Zentralbl Chir. 1998;123(2):193–5.

    CAS  PubMed  Google Scholar 

  16. Langeveld HR, et al. Total extraperitoneal inguinal hernia repair compared with Lichtenstein (the LEVEL-Trial): a randomized controlled trial. Ann Surg. 2010;251(5):819–24.

    Article  PubMed  Google Scholar 

  17. Ulrych J, et al. 28 day post-operative persisted hypercoagulability after surgery for benign diseases: a prospective cohort study. BMC Surg. 2016;16:16.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Garg P, et al. Laparoscopic total extraperitoneal inguinal hernia repair with nonfixation of the mesh for 1,692 hernias. Surg Endosc. 2009;23(6):1241–5.

    Article  PubMed  Google Scholar 

  19. Ferzli GS, Massad A, Albert P. Extraperitoneal endoscopic inguinal hernia repair. J Laparoendosc Surg. 1992;2(6):281–6.

    Article  CAS  PubMed  Google Scholar 

  20. Chowbey PK, et al. Extraperitoneal endoscopic groin hernia repair under epidural anesthesia. Surg Laparosc Endosc Percutan Tech. 2003;13(3):185–90.

    Article  CAS  PubMed  Google Scholar 

  21. Tamme C, et al. Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc. 2003;17(2):190–5.

    Article  CAS  PubMed  Google Scholar 

  22. Arregui ME, Young SB. Groin hernia repair by laparoscopic techniques: current status and controversies. World J Surg. 2005;29(8):1052–7.

    Article  PubMed  Google Scholar 

  23. Misra MC, Kumar S, Bansal VK. Total extraperitoneal (TEP) mesh repair of inguinal hernia in the developing world: comparison of low-cost indigenous balloon dissection versus direct telescopic dissection: a prospective randomized controlled study. Surg Endosc. 2008;22(9):1947–58.

    Article  PubMed  Google Scholar 

  24. Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc. 2004;18(2):221–7.

    Article  CAS  PubMed  Google Scholar 

  25. Bringman S, et al. Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study. Surg Laparosc Endosc Percutan Tech. 2001;11(5):322–6.

    Article  CAS  PubMed  Google Scholar 

  26. Ramshaw B, et al. Laparoscopic inguinal hernia repair: lessons learned after 1224 consecutive cases. Surg Endosc. 2001;15(1):50–4.

    Article  CAS  PubMed  Google Scholar 

  27. Liem MS, et al. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med. 1997;336(22):1541–7.

    Article  CAS  PubMed  Google Scholar 

  28. Miserez M, et al. A standardized resident training program in endoscopic surgery in general and in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in particular. Surg Laparosc Endosc Percutan Tech. 2009;19(4):e125–9.

    Article  PubMed  Google Scholar 

  29. Sayad P, et al. Incidence of incipient contralateral hernia during laparoscopic hernia repair. Surg Endosc. 2000;14(6):543–5.

    Article  CAS  PubMed  Google Scholar 

  30. Lau H, et al. Management of peritoneal tear during endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc. 2002;16(10):1474–7.

    Article  CAS  PubMed  Google Scholar 

  31. Ramser M. et al. Incarcerated obturator hernia-laparoscopic repair with intraoperative view of the corona mortis. J Surg Case Rep. 2014;2014(8). doi:10.1093/jscr/rju081.

  32. Moreno-Egea A, et al. Vascular injury by tacks during totally extraperitoneal endoscopic inguinal hernioplasty. Surg Laparosc Endosc Percutan Tech. 2010;20(3):e129–31.

    Article  PubMed  Google Scholar 

  33. Ates M. et al. Corona mortis: in vivo anatomical knowledge and the risk of injury in totally extraperitoneal inguinal hernia repair. Hernia. 2016–20(5):659–65.

    Google Scholar 

  34. Lal P, et al. Laparoscopic total extraperitoneal (TEP) inguinal hernia repair under epidural anesthesia: a detailed evaluation. Surg Endosc. 2007;21(4):595–601.

    Article  PubMed  Google Scholar 

  35. Ferzli G, et al. Laparoscopic extraperitoneal approach to acutely incarcerated inguinal hernia. Surg Endosc. 2004;18(2):228–31.

    Article  CAS  PubMed  Google Scholar 

  36. Reddy VM, et al. Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Hernia. 2007;11(5):393–6.

    Article  CAS  PubMed  Google Scholar 

  37. Shadduck PP, Schwartz LB, Eubanks S. Laparoscopic inguinal herniorrhaphy. In: Nyhus LM, Condon R, editors. Hernia. 5th ed. Philadelphia: Lippincott; 2002.

    Google Scholar 

  38. Champault GG, et al. Inguinal hernia repair: totally preperitoneal laparoscopic approach versus Stoppa operation: randomized trial of 100 cases. Surg Laparosc Endosc. 1997;7(6):445–50.

    Article  CAS  PubMed  Google Scholar 

  39. Kapiris S, et al. Laparoscopic transabdominal preperitoneal hernia repair (TAPP): stapling the mesh is not mandatory. J Laparoendosc Adv Surg Tech A. 2009;19(3):419–22.

    Article  PubMed  Google Scholar 

  40. Teng YJ, et al. A meta-analysis of randomized controlled trials of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair. Surg Endosc. 2011;25(9):2849–58.

    Article  PubMed  Google Scholar 

  41. Chan MS, et al. Randomized double-blinded prospective trial of fibrin sealant spray versus mechanical stapling in laparoscopic total extraperitoneal hernioplasty. Ann Surg. 2014;259(3):432–7.

    Article  PubMed  Google Scholar 

  42. Tolver MA, et al. Randomized clinical trial of fibrin glue versus tacked fixation in laparoscopic groin hernia repair. Surg Endosc. 2013;27(8):2727–33.

    Article  PubMed  Google Scholar 

  43. Daes J. The enhanced view-totally extraperitoneal technique for repair of inguinal hernia. Surg Endosc. 2012;26(4):1187–9.

    Article  PubMed  Google Scholar 

  44. Daes J. Endoscopic repair of large inguinoscrotal hernias: management of the distal sac to avoid seroma formation. Hernia. 2014;18(1):119–22.

    Article  CAS  PubMed  Google Scholar 

  45. Simons MP, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343–403.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Atila K, et al. Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study. Langenbecks Arch Surg. 2010;395(5):563–8.

    Article  PubMed  Google Scholar 

  47. Leibl BJ, et al. Laparoscopic transperitoneal hernia repair of incarcerated hernias: Is it feasible? Results of a prospective study. Surg Endosc. 2001;15(10):1179–83.

    Article  CAS  PubMed  Google Scholar 

  48. Bansal VK, et al. A prospective, randomized comparison of long-term outcomes: chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surg Endosc. 2013;27(7):2373–82.

    Article  PubMed  Google Scholar 

  49. Kocot A, Gerharz EW, Riedmiller H. Urological complications of laparoscopic inguinal hernia repair: a case series. Hernia. 2011;15(5):583–6.

    Article  CAS  PubMed  Google Scholar 

  50. Tam KW, Liang HH, Chai CY. Outcomes of staple fixation of mesh versus nonfixation in laparoscopic total extraperitoneal inguinal repair: a meta-analysis of randomized controlled trials. World J Surg. 2010;34(12):3065–74.

    Article  PubMed  Google Scholar 

  51. Sivasankaran MV, Pham T, Divino CM. Incidence and risk factors for urinary retention following laparoscopic inguinal hernia repair. Am J Surg. 2014;207(2):288–92.

    Article  PubMed  Google Scholar 

  52. Gong K, et al. Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc. 2011;25(1):234–9.

    Article  PubMed  Google Scholar 

  53. McCormack K et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785.

    Google Scholar 

  54. Grant AM, et al. Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg. 2004;91(12):1570–4.

    Article  CAS  PubMed  Google Scholar 

  55. Eklund A, et al. Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg. 2010;97(4):600–8.

    Article  CAS  PubMed  Google Scholar 

  56. Bittner R, Sauerland S, Schmedt CG. Comparison of endoscopic techniques vs Shouldice and other open nonmesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc. 2005;19(5):605–15.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Mohammed Al Mahroos M.D., F.R.C.S(C) .

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Al Mahroos, M., Vassiliou, M. (2017). Laparoscopic Totally Extraperitoneal (TEP) Inguinal Hernia Repair. In: Hope, W., Cobb, W., Adrales, G. (eds) Textbook of Hernia. Springer, Cham. https://doi.org/10.1007/978-3-319-43045-4_13

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  • DOI: https://doi.org/10.1007/978-3-319-43045-4_13

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