A retrospective comparative study of the enhanced view-totally extraperitoneal technique versus the traditional totally extraperitoneal technique in managing recurrent inguinal hernias

Abdullah Hilmi Yilmaz ¹, Mehmet Esref Ulutas ²

⁰Department of Surgery, Antalya Training and Research Hospital, University of Health Sciences, Varlık Mh. Kazım Karabekir Cd. 07100, Antalya, Türkiye. drabdullahhilmi@gmail.com.

Bmc Surgery +

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August 9, 2025

View abstract on PubMed

Summary

The laparoscopic enhanced view-total extraperitoneal (eTEP) and total extraperitoneal (TEP) techniques are equally safe and effective for treating recurrent inguinal hernias, showing no significant differences in recurrence or recovery times.

Area Of Science

Minimally Invasive Surgery
Surgical Oncology
Gastroenterology

Background

International guidelines advocate for laparoscopic surgery in recurrent inguinal hernias post-anterior repair.
The optimal laparoscopic technique for these cases remains undetermined.
This study compares the safety and efficacy of eTEP versus TEP for recurrent inguinal hernias.

Purpose Of The Study

To evaluate the safety and efficacy of the laparoscopic enhanced view-total extraperitoneal (eTEP) technique.
To compare eTEP with the total extraperitoneal (TEP) technique in treating recurrent inguinal hernias.
To assess outcomes including recurrence rates, operation time, and postoperative complications.

Main Methods

A retrospective cohort study involving 62 patients with unilateral recurrent inguinal hernias after anterior repair.
Patients underwent either the eTEP or TEP technique between February 2023 and February 2024.
Demographic, surgical, and postsurgical data were compared, with recurrence and operation time as primary outcomes.

Main Results

No recurrences were observed in either the eTEP (n=32) or TEP (n=30) group over an 18.3-month follow-up.
Mean operative times were similar (eTEP: 44.4 min vs. TEP: 45.7 min, p=0.62).
Postoperative outcomes, including return to activities, chronic pain, and complication rates (hematoma, seroma), were comparable between the groups.

Conclusions

The eTEP technique shows comparable outcomes to TEP for recurrent inguinal hernias regarding recurrence, operation time, and postoperative recovery.
Both eTEP and TEP are safe and viable laparoscopic options for managing recurrent inguinal hernias.
Further prospective randomized studies are needed to definitively compare these two techniques.

Keywords:

Recurrent Recurrent inguinal hernia repair eTEP