Favorable outcomes of transabdominal compared with transinguinal preperitoneal inguinal hernia repair

Introduction The present study was performed to compare postoperative pain following transinguinal preperitoneal repair (TIPP) and transabdominal preperitoneal repair (TAPP) performed by a single surgeon with adequate experience in each procedure. Material and methods Adult patients who underwent herniorrhaphy for elective unilateral primary inguinal hernia repair from April 2013 to October 2019 were identified. After propensity score matching, a numeric rating scale was used to compare postoperative pain scores at 1 day, 1 week, and 1 month between patients who underwent TAPP and TIPP. Results Among 784 patients who underwent herniorrhaphy during the study period, 354 were analyzed by propensity score matching (TAPP, n = 177; TIPP, n = 177). Postoperative pain during normal activity was significantly lower in the TAPP group than in the TIPP group on day 1 (2.75 +/- 1.67 versus 3.59 +/- 1.86, p < 0.01), at 1 week (0.98 +/- 1.11 versus 1.75 +/- 1.51, p < 0.01), and at 1 month (0.11 +/- 0.48 versus 0.29 +/- 0.78, p = 0.01). There was no difference in pain at rest on day 1 and at one week, although TAPP was associated with significantly less pain at rest at one month than was TIPP (0.01 +/- 0.08 versus 0.1 +/- 0.49, p = 0.02). Conclusion TAPP is preferable to TIPP in patients undergoing elective unilateral primary inguinal hernia repair in terms of reducing short-term pain.