A comparative study on optical trocar entry vs. balloon trocar entry in laparoscopic eTEP inguinal hernia repair - a randomised control trial.

BACKGROUND

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).

MATERIALS AND METHODS

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.

RESULTS

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).

CONCLUSION

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.