Comparison of minimally invasive preperitoneal (MIP) single-layer mesh repair and total extraperitoneal (TEP) repair for inguinal hernia in terms of postoperative chronic pain: a prospective randomized trial
Nergis Aksoy1, Kemal Arslan1, Osman Doğru1, Ömer Karahan2, Mehmet Ali Eryılmaz1
1Clinic of General Surgery, Konya Education and Research Hospital, Konya, Turkey
2Department of General Surgery, Usak University School of Medicine, Usak, Turkey
Objective: The aim of this study was to compare minimally invasive preperitoneal (MIP) single layer mesh repair with total extraperitoneal (TEP) inguinal hernia repair in terms of complications, recurrence, and chronic pain.
Material and Methods: A total of 240 patients who underwent elective, primary, unilateral inguinal hernia operation between April 2011 and September 2012 were divided into two randomized groups. The first group underwent MIP repair and the second group underwent TEP repair. Visual Analogue Scale (VAS) and Sheffield Scale (SS) were used to evaluate chronic pain.
Results: In all, 225 (95%) of the patients completed follow-up and were included in analyses. A significant difference was not detected between groups in terms of demographics, operative time, or intraoperative, early, or late complications. Length of time before return to work was significantly shorter in the TEP group (p< 0.001). Recurrence was seen in 1 (0.88%) patient in the MIP group and 1 (0.89%) patient in the TEP group (p= 0.993). Evaluation of chronic pain revealed no significant difference between groups in VAS and SS values at postoperative 6th, 12th, and 24th months.
Conclusion: In conclusion, it was observed that MIP repair for inguinal hernia has all of the advantages of preperitoneal repair and eliminates disadvantages of TEP repair. MIP technique is as safe as TEP repair and has similar qualities in terms of chronic pain, even though it is an open intervention.
Keywords: Chronic pain, inguinal hernia, preperitoneal repair, total extra peritoneal repair
Cite this article as: Aksoy N, Arslan K, Doğru O, Karahan Ö, Eryılmaz MA. Comparison of minimally invasive preperitoneal (MIP) single-layer mesh repair and total extraperitoneal (TEP) repair for inguinal hernia in terms of postoperative chronic pain. Turk J Surg 2019; 35 (1): 35-43
This prospective, randomized study was conducted at the General Surgery Clinic of Konya Education and Research Hospital after having received approval of the ethics committee of Uşak University Medical School.
Written informed consent was obtained from patients who participated in this study.
Consept - N.A., K.A., O.D.; Design - N.A., K.A.; Supervision - Ö.K., M.A.E., N.A.; Resource - O.D., N.A.; Materials - N.A.; Data Collection and/or Processing - N.A.; Analysis and Interpretation - N.A., K.A.; Literature Search - O.D., Ö.K., M.A.E.; Writing Manuscript - N.A., K.A., O.D., Critical Reviews - O.D., K.A., N.A.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.