Prospective Comparative Study between Conventional TAPP and Tumescent TAPP. | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 17, Issue 4, October 2024, Page 293-299 PDF (424.29 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ASJS.2024.313091.1156 | ||||
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| Authors | ||||
| Dina Hany* ; Mohammed Abdo Hamouda; Mohamed Elnagar | ||||
| Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Introduction: Transabdominal preperitoneal approach (cTAPP) is effective method in treatment of inguinal hernia. Technical difficulties and long learning curve are the main disadvantages. We suggest that tumescent injection in the preperitoneal space during TAPP before dissection may facilitate technical difficulties and decrease the learning curve with subsequent improvement of the competence of the trainee to do the surgery. Patients and methods: From March 2020 to March 2022, our study enrolled 200 patients, evenly split between those receiving conventional TAPP (cTAPP) and Tumescent TAPP (tTAPP). The surgeries were performed by trainees under supervision. The surgical procedure involved injecting a mixture of 50 ml of 0.5% Bupivacaine and adrenaline diluted to 1 in 200,000 into the extraperitoneal space. The rest of the operation was consistent with the conventional techniques of TAPP repair. Results: There was a highly significant difference between both study groups as regards operative time with higher mean time among cTAPP cases. There was a highly significant difference between both study groups as regards pain score 24 hours after operation with higher mean time among cTAPP cases. Yet, no significant difference was found in pain score 2 weeks, 30 days and 1 year after operation. Regarding the competence and learning of the trainees, there was significant difference in overall competence with favor to tTAPP group. Conclusion: The application of Tumescent technique in TAPP surgery could potentially reduce the learning curve, abbreviate the duration of the operation, and alleviate postoperative discomfort for patients when contrasted with the traditional TAPP method. | ||||
| Keywords | ||||
| Laparoscopic inguinal hernia repair; Laparoscopic transabdominal preperitoneal hernia repair (cTAPP); Tumescent laparoscopic transabdominal preperitoneal hernia repair (tTAPP) | ||||
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