TAPP vs TEP: a retrospective analysis 5 years after laparoscopic transperitoneal and total extraperitoneal repair in inguinal and femoral hernia

Introduction. The 5-year results after laparoscopic repair of inguinal and femoral hernias with the TAPP and TEP techniques were analyzed. Methods. We examined all patients after inguinal repair with the TAPP or TEP technique for the treatment of inguinal and/or femoral hernias from September 1992 to February 1996 performed by four surgeons at the Luneburg community hospital (TAPP: 294 patients with 352 hernias,TEP: 278 patients with 324 hernias). The follow-up included a clinical examination, a questionnaire, and an ultrasound examination of the inguinal area. Results. The follow-up rate was 93.5% after TAPP and 91% after TEP with a median follow-up of 5.7 postoperative years. With a total complication rate of almost 10.2% both methods did not differ. The recurrence rate after TAPP was 2.3% ( re-recurrence rate 6.7%) and 1.5% after TEP ( re-recurrence rate 4.8%). Recurrences occurred on average 45 months after TAPP and 36.6 months after TEP. Conclusion. TAPP and TEP are both safe and efficient. Because of the late occurrence of recurrence we suggest randomized prospective studies over a period of 5-10 postoperative years.