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Modified Open Anterior Preperitoneal Repair.

Rajeev Sinha1, Albail S Yadav1, Yasharth Sharma1

  • 1Department of Surgery, Maharani Laxmi Bai Medical College, Jhansi, India (all authors).

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|December 4, 2023
PubMed
Summary
This summary is machine-generated.

Modified anterior preperitoneal (mAPP) repair offers a faster operating time and reduced pain compared to Lichtenstein repair (LR) for inguinal hernias (IH). It also shows benefits similar to laparoscopic transabdominal preperitoneal (TAPP) repair.

Keywords:
Inguinal herniaLaparoscopic transabdominal preperitoneal (TAPP) repairLichtenstein repairModified anterior preperitoneal repair (mAPP)Transinguinal preperitoneal repair (TIPP)

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Area of Science:

  • Surgical Innovation
  • Hernia Repair Techniques
  • Minimally Invasive Surgery

Background:

  • Inguinal hernia (IH) repair is a common surgical procedure.
  • Existing methods include Lichtenstein repair (LR) and laparoscopic transabdominal preperitoneal (TAPP) repair.
  • Modified anterior preperitoneal (mAPP) repair is a newer technique for IH.

Purpose of the Study:

  • To compare the efficacy and outcomes of modified anterior preperitoneal (mAPP) repair with Lichtenstein repair (LR) and laparoscopic transabdominal preperitoneal (TAPP) repair for inguinal hernias (IH).

Main Methods:

  • Randomized controlled trial involving IH patients.
  • Comparison of mAPP, LR, and TAPP repair groups.
  • Statistical analysis of predefined endpoints including operating time, recovery, pain scores, and recurrence rates.

Main Results:

  • mAPP repair demonstrated significantly shorter operating times compared to both LR and TAPP.
  • Postoperative pain scores (VAS) were initially lower with mAPP than LR, but higher than TAPP.
  • Chronic pain and recurrence rates were comparable across all three methods, with TAPP showing the least chronic pain.

Conclusions:

  • Modified anterior preperitoneal (mAPP) repair is a favorable open surgical option for inguinal hernias (IH).
  • mAPP repair offers advantages comparable to laparoscopic approaches.
  • Further research may explore long-term outcomes and patient selection for mAPP.