Chitrambalam Tharun Ganapathy, Harshan K S Suryaa, Ramanathan Ramprakash, Vijayakumar Muthuvignesh, Gilani Amit Salim
SRM Medical College & Research Centre, SRM Institute of Science and Technology, SRM nagar, Kattankulathur, Chengalpattu, Tamilnadu, 603203, India.
Hernia. 2025 Apr 8;29(1):139. doi: 10.1007/s10029-025-03329-4.
The enhanced Totally Extra-Peritoneal (eTEP) technique is a novel minimally invasive approach to inguinal hernia repair that involves entry into the retro-rectus space and dissection of preperitoneal spaces. Aim of this study is to compare two methods for creating the preperitoneal space: optical trocar dissection (Group A) and balloon trocar dissection (Group B).
A prospective, single-blinded, interventional study was conducted with 116 patients, randomized into two groups (58 in each group) undergoing eTEP inguinal hernia repair at SRM Medical College Hospital, India. Key outcomes assessed included the duration of surgery, intraoperative complications, postoperative pain, and postoperative occurences such as seroma and hematoma.
The study found that balloon trocar dissection resulted in significantly shorter surgery duration (mean 62 min vs. 75 min, p<0.001) and quicker preperitoneal space creation (13 min vs. 19 min, p<0.0001). Balloon dissection also showed fewer incidents of peritoneal breaches (0% vs. 10.34%, p<0.002), lower postoperative pain scores, and a lower incidence of seroma and hematoma formation (1.72% vs. 17.24%, p<0.004).
These findings suggest that balloon trocar dissection is a safer, more efficient method for eTEP inguinal hernia repair, offering a smoother learning curve for surgeons, especially during the early stages of the procedure.
改良完全腹膜外（eTEP）技术是一种用于腹股沟疝修补的新型微创方法，该方法需要进入腹直肌后间隙并分离腹膜前间隙。本研究的目的是比较两种创建腹膜前间隙的方法：光学套管针分离法（A组）和球囊套管针分离法（B组）。
在印度SRM医学院附属医院对116例患者进行了一项前瞻性、单盲、干预性研究，将患者随机分为两组（每组58例），接受eTEP腹股沟疝修补术。评估的主要结果包括手术时间、术中并发症、术后疼痛以及术后血清肿和血肿等情况。
研究发现，球囊套管针分离法的手术时间明显更短（平均62分钟对75分钟，p<0.001），创建腹膜前间隙更快（13分钟对19分钟，p<0.0001）。球囊分离法还显示腹膜破损事件更少（0%对10.34%，p<0.002），术后疼痛评分更低，血清肿和血肿形成的发生率也更低（1.72%对17.24%，p<0.004）。
这些发现表明，球囊套管针分离法是一种更安全、更有效的eTEP腹股沟疝修补方法，为外科医生提供了更平滑的学习曲线，尤其是在手术早期阶段。
