Low Pneumoperitoneum Pressure Improves Recovery of Transabdominal Preperitoneal Hernioplasty

To evaluate the recovery influence of CO₂ pneumoperitoneum pressure for transabdominal preperitoneal hernioplasty (TAPP).

Experimental study.

General Department II, Zhongda Hospital, Southeast University, Nanjing, China, from August 2016 to October 2018.

Eighty cases were enrolled prospectively and divided into three groups in chronological order. A 14 mmHg CO2 pressure was used for negative control group while the pressure was controlled at 12 mmHg for observation group and 10 mmHg for intervention group. General information included the patients' age, gender, type of hernia, hernia defect size, dissection of inguinal area, type of patch, time of operation, and frequency of swelling of perineum. Postoperative recovery was compared among the three groups at 24 hours and 1 month after surgery, including pain scores, foreign body sensation, local complications, urinary retention, swelling of the perineum, sex life and mobility.

Seventy-eight patients were included in the final analysis. There were no differences among the three groups in patients' age, gender, type of hernia, hernia defect size, dissection of inguinal area and type of patch. However, the time of operation of intervention group increased (p=0.015) and incidence of swelling of perineum decreased than other two groups (p<0.05). After 24 hours, there were no significant differences in pain, foreign body sensation, local complications and urinary retention. Perineal swelling remission rate of intervention group was better than other two groups (p<0.05). After one month, three groups had no differences in the all terms of pain, foreign body sensation, sexual life and perineal swelling residual rate.

Low pneumoperitoneum pressure can relieve swelling of perineum perioperatively and improve recovery of TAPP.