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Surgical Endoscopy
Published in: Surgical Endoscopy 2/2007

01-02-2007

Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review

Authors: E. Kuhry, R. N. van Veen, H. R. Langeveld, E. W. Steyerberg, J. Jeekel, H. J. Bonjer

Published in: Surgical Endoscopy | Issue 2/2007

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Abstract

Background

Although a large number of surgeons currently perform endoscopic hernia surgery using a total extraperitoneal (TEP) approach, reviews published to date are based mainly on trials that compare laparoscopic transabdominal preperitoneal (TAPP) repair with various types of open inguinal hernia repair.

Methods

A qualitative analysis of randomized trials comparing TEP with open mesh or sutured repair.

Results

In this review, 4,231 patients were included in 23 trials. In 10 of 15 trials, TEP repair was associated with longer surgery time than open repair. A shorter postoperative hospital stay after TEP repair than after open repair was reported in 6 of 11 trials. In 8 of 9 trials, the time until return to work was significantly shorter after TEP repair. Hospital costs were significantly higher for TEP than for open repair in all four trials that included an economic evaluation. Most trials (n = 14) reported no differences in subsequent recurrence rates between TEP and open repair.

Conclusions

The findings showed that endoscopic TEP repair is associated with longer surgery time, shorter postoperative hospital stay, earlier return to work, and recurrence rates similar to those for open inguinal hernia repair. The procedure involves greater expenses for hospitals, but appears to be cost effective from a societal perspective. The TEP technique is a serious option for mesh repair of primary hernias.
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Metadata
Title
Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review
Authors
E. Kuhry
R. N. van Veen
H. R. Langeveld
E. W. Steyerberg
J. Jeekel
H. J. Bonjer
Publication date
01-02-2007
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 2/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-0167-4

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