INGUINAL HERNIOPLASTY

LAPAROSCOPIC TEP WITH & WITHOUT DISSECTION BALLOON

Abstract

Objective: To compare laparoscopic TEP Inguinal hernioplasty with & without
dissection balloon. Study Design: Observational study. Setting: Minimal Invasive Surgical
Centre Jamshoro and General Surgical Department at Dow University Hospital, Ojha Campus
Karachi. Period: May 2011 and Dec 2012. Subjects and methods: Twenty (20) male patients
with uncomplicated unilateral or bilateral inguinal hernia were prospectively randomized in two
groups; group A Commercially available dissection balloon & group B. Telescopic dissection
for creating TEP working space. Results: We had 20 male patients for this study. The average
age was 43.6 & ranging between 17 to 64 years. Only 2 patients 10% had bilateral groin hernia,
4 patients 40% had direct inguinal hernia in group A & 5 patients 50% had direct hernia in group
B. Peritoneum was breached in 5 (50%) patients with telescopic dissection. One patient (10%)
with bilateral groin hernia in group B had large tear in peritoneum converted to TAPP while
other group normal. The incidence of scrotal edema/seroma was greater in group B then group
A. 40% patient in group B developed seroma while 0nly 1 (10%) patient with bilateral groin
hernia in group A developed seroma. Pain was scored on VAS at 1 & 4 hours after surgery
was higher in group B. The mean operation time was 55 min (45-100) in the group with the
balloon and 73 min (50-120) in the group without the balloon (p = 0.004). Conclusion: TEP
laparoscopic inguinal hernia repair is probably the best option amongst the two techniques
used in laparoscopic inguinal hernia repair & dissection with balloon is though costly but more
helpful in dissection & safer.