A New Suture Technique for Peritoneal Flap Closure in TAPP: A Prospective Randomized Controlled Trial

To facilitate the suture step, we describe a new suture method for laparoscopic closure of the peritoneal flap in transabdominal preperitoneal (TAPP). A prospective randomized controlled trial was carried out to evaluate the efficacy of the new suture method compared with the conventional method.

Eighty patients who presented to our hospital in May 2019 with primary unilateral inguinal hernia were randomized into the conventional suture method group and the new suture group for TAPP repairs. The primary outcome was the suture time to complete the peritoneal flap closure. Secondary outcomes included the number of cases of peritoneum tearing, need for additional suture, and suture line breaking.

The suture time in the new suture method group was significantly shorter than that of the conventional group (715.3±132.4 s vs. 840.71±137.9 s, P<0.001); furthermore, there were significantly less number of cases of peritoneal tearing in the new suture method group than in the conventional suture method group (4 vs. 11, P<0.01).

The new suture method is relatively easy to learn for beginners performing TAPP procedures, as compared with the conventional method, and less peritoneal tearing is encountered when using this method for peritoneal flap closure.