Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial

Background: Totally extraperitoneal (TEP) repair involves creating a preperitoneal space. The preperitoneal space can be created by balloon or telescopic dissection (TD). Nevertheless, these techniques may have some complications. However, there are very few studies that compare these two techniques...

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Main Authors: Rajanna Varun, Oseen Hajilal Shaikh, Prakash Sagar, Chellappa Vijayakumar, Gopal Balasubramanian, Uday Shamrao Kumbhar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of Minimal Access Surgery
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Online Access:https://journals.lww.com/10.4103/jmas.jmas_373_23
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author Rajanna Varun
Oseen Hajilal Shaikh
Prakash Sagar
Chellappa Vijayakumar
Gopal Balasubramanian
Uday Shamrao Kumbhar
author_facet Rajanna Varun
Oseen Hajilal Shaikh
Prakash Sagar
Chellappa Vijayakumar
Gopal Balasubramanian
Uday Shamrao Kumbhar
author_sort Rajanna Varun
collection DOAJ
description Background: Totally extraperitoneal (TEP) repair involves creating a preperitoneal space. The preperitoneal space can be created by balloon or telescopic dissection (TD). Nevertheless, these techniques may have some complications. However, there are very few studies that compare these two techniques. This study aims to assess the impact and comprehensively compare the TD and balloon dissection (BD) methods in patients undergoing laparoscopic TEP inguinal hernia repair. Patients and Methods: This was a single-centre, double-blinded, prospective, randomised, controlled trial comparing BD and TD for the creation of the preperitoneal space. The primary end point was to compare the post-operative pain score, intraoperative complications and surgical site occurrence between the two groups. The secondary end point was to assess the impact of the dissection technique on operative time for the creation of extraperitoneal space during laparoscopic TEP inguinal hernia repair. Results: A total of 46 patients were included in the study (23 in each group). Baseline parameters were comparable between the groups. The total operative time between the groups (120 min vs. 160 min; P < 0.005) was statistically significant. The incidence of the peritoneal breach was statistically less in the BD group (43% vs. 13%; P < 0.005). Other short-term and long-term complications were less in the BD group but not statistically significant. Conclusions: BD in TEP inguinal hernia repair reduces the operative time and peritoneal breach. When compared to TD in terms of operative time, routine use of BD can be proposed. It will be beneficial in the early part of the learning curve.
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spelling doaj-art-2cd7bb05b37a424686d4cfada9ba11872025-08-20T02:57:16ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212025-04-0121213314010.4103/jmas.jmas_373_23Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trialRajanna VarunOseen Hajilal ShaikhPrakash SagarChellappa VijayakumarGopal BalasubramanianUday Shamrao KumbharBackground: Totally extraperitoneal (TEP) repair involves creating a preperitoneal space. The preperitoneal space can be created by balloon or telescopic dissection (TD). Nevertheless, these techniques may have some complications. However, there are very few studies that compare these two techniques. This study aims to assess the impact and comprehensively compare the TD and balloon dissection (BD) methods in patients undergoing laparoscopic TEP inguinal hernia repair. Patients and Methods: This was a single-centre, double-blinded, prospective, randomised, controlled trial comparing BD and TD for the creation of the preperitoneal space. The primary end point was to compare the post-operative pain score, intraoperative complications and surgical site occurrence between the two groups. The secondary end point was to assess the impact of the dissection technique on operative time for the creation of extraperitoneal space during laparoscopic TEP inguinal hernia repair. Results: A total of 46 patients were included in the study (23 in each group). Baseline parameters were comparable between the groups. The total operative time between the groups (120 min vs. 160 min; P < 0.005) was statistically significant. The incidence of the peritoneal breach was statistically less in the BD group (43% vs. 13%; P < 0.005). Other short-term and long-term complications were less in the BD group but not statistically significant. Conclusions: BD in TEP inguinal hernia repair reduces the operative time and peritoneal breach. When compared to TD in terms of operative time, routine use of BD can be proposed. It will be beneficial in the early part of the learning curve.https://journals.lww.com/10.4103/jmas.jmas_373_23balloon dissectionelective hernia repairlaparoscopic hernia repairtelescopic dissectiontotally extraperitoneal repair
spellingShingle Rajanna Varun
Oseen Hajilal Shaikh
Prakash Sagar
Chellappa Vijayakumar
Gopal Balasubramanian
Uday Shamrao Kumbhar
Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial
Journal of Minimal Access Surgery
balloon dissection
elective hernia repair
laparoscopic hernia repair
telescopic dissection
totally extraperitoneal repair
title Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial
title_full Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial
title_fullStr Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial
title_full_unstemmed Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial
title_short Telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair: A prospective randomised control trial
title_sort telescopic dissection versus balloon dissection during laparoscopic totally extraperitoneal inguinal hernia repair a prospective randomised control trial
topic balloon dissection
elective hernia repair
laparoscopic hernia repair
telescopic dissection
totally extraperitoneal repair
url https://journals.lww.com/10.4103/jmas.jmas_373_23
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AT prakashsagar telescopicdissectionversusballoondissectionduringlaparoscopictotallyextraperitonealinguinalherniarepairaprospectiverandomisedcontroltrial
AT chellappavijayakumar telescopicdissectionversusballoondissectionduringlaparoscopictotallyextraperitonealinguinalherniarepairaprospectiverandomisedcontroltrial
AT gopalbalasubramanian telescopicdissectionversusballoondissectionduringlaparoscopictotallyextraperitonealinguinalherniarepairaprospectiverandomisedcontroltrial
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