Efficacy of extended view totally extra peritoneal approach versus laparoscopic intraperitoneal on lay mesh plus for abdominal wall hernias: a single center preliminary study

Abstract

Abstract Background Minimally invasive surgery through Laparoscopy had been the first treatment option for ventral hernias. Laparoscopic intraperitoneal on lay mesh (IPOM) plus approach for abdominal wall hernias is the classic procedure, while extended view totally extraperitoneal (e‑TEP) repair is a newer option. This study aimed to compare the preliminary effects of the two surgical procedures for abdominal wall hernias repair. Methods This is a retrospective and comparative single-center study done at The Second Clinical Medical College, Jinan University Hospital (Shenzhen People's Hospital), Shenzhen, China, from January 2022 to December 2022. The study included all patients who had undergone abdominal wall hernia operation with a 2 to 6-cm defect size. Patients' baseline characteristics, hernia features, operative time, blood loss, postoperative pain level, and total hospitalization expenses were conducted systematically. Results We evaluated 53 cases, 22 in the e-TEP group and 31 in IPOM plus group. The demographic characteristics had no significant difference between the two groups. The time of surgery in e-TEP was significantly longer than IPOM plus (98.5 ± 10.7min vs. 65.9 ± 7.3min, P < 0.01). Postoperative pain levels (VAS) (4.2 ± 0.9 vs. 6.7 ± 0.9, P < 0.01), analgesic requirements (25.0 ± 37.0mg vs. 72.6 ± 40.5mg, P < 0.01), hospital stays (1.2 ± 0.5days vs. 2.2 ± 0.6days, P < 0.01), and total hospitalization expenses (19695.9 ± 1221.7CNY vs. 35286.2 ± 1196.6CNY, P < 0.01) by contrast were significantly lower for the e-TEP group. There was no difference in the mean intraoperative bleeding between the two groups and no postoperative complications during the observation period in the two groups. Conclusion As a new surgical technique for abdominal wall hernias repair, e-TEP appears to be better than IPOM plus in postoperative pain levels (VAS), analgesic requirements, hospital stays and hospitalization costs.