Gerber S, Hämmerli P A, Glättli A
Chirurgische Klinik, Zieglerspital Bern.
Chirurg. 2000 Jul;71(7):824-8. doi: 10.1007/s001040051142.
Since the introduction of laparoscopic hernioplasty the TAPP procedure (transabdominal preperitoneal approach) has become the most widely used technique. Many surgeons have changed to the total extraperitoneal approach (TEP), because they fear the consequences of a peritoneal lesion.
We evaluated our results with TAPP in a retrospective study, with special attention to complications caused by the approach. We operated on 460 hernias in 390 patients in a period of 5 years.
Complication rates and recurrence rates were similar to those after TEP. There was a marked learning curve with decrease of both rates during the evaluated years. There were no complications related to the transabdominal approach other than trocar hernias, the rate of which could be reduced by eliminating the learning curve and by using smaller trocar diameter.
We see no reason to change from TAPP to the TEP technique.