A Randomised Comparison of Extended View Totally Extraperitoneal Repair (eTEP) and Conventional Totally...

Inguinal hernia is a common surgical condition requiring definitive repair. While totally extraperitoneal repair (TEP) is a widely used laparoscopic approach, its limitations include restricted space for dissection and a steep learning curve. The extended view totally extraperitoneal repair (eTEP) technique was developed to address these issues by providing a larger surgical field and improved port placement. This study aimed to evaluate the efficiency, benefits, limitations, surgery duration, hospital stay, and recurrence rates of eTEP, comparing its outcomes with conventional TEP in inguinal hernia repair.

A randomised comparative study was conducted on 36 patients with a primary inguinal hernia at ABVIMS and Dr. RML Hospital over 2 years. Patients were divided into two groups (TEP and eTEP, with 18 in each). Variables, such as operative time, postoperative pain, hospital stay, and recurrence, were assessed. Statistical analysis included Mann-Whitney, t-tests, and chi-square tests, with a significance level of P < 0.05.

The mean operative time was 78.89 min for TEP and 82.50 min for eTEP, with no statistically significant difference (P = 0.413). One conversion to open surgery occurred in the TEP group, while none occurred in the eTEP group. There was one case of vascular injury in the TEP group, but no visceral or nerve injuries in either group. Postoperative pain scores, hospital stay duration, and recurrence rates showed no significant differences between groups.

eTEP is comparable to TEP in terms of perioperative outcomes. Although eTEP takes slightly longer, it has fewer complications and a lower conversion rate. Both techniques are equally effective for laparoscopic inguinal hernia repair.