Is a dissection balloon beneficial in totally extraperitoneal endoscopic hernioplasty (TEP)? A randomized prospective multicenter study

Surgical Endoscopy
S BringmanB Anderberg

Abstract

Laparoscopic hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to facilitate the creation of the initial working space in totally extraperitoneal endoscopic hernioplasty (TEP), but their use adds to the cost of the operation. A total of 322 men with unilateral, primary, or recurrent inguinal hernias were randomized to undergo TEP with or without a dissection balloon. In the group with the balloon, three of 161 patients (2.5%) required conversion to transabdominal preperitoneal hernioplasty (TAPP), or open herniorraphy, whereas 17 of 161 patients (10.6%) were converted to TAPP or open herniorraphy in the group without the balloon (p = 0.002). The mean operation time was 55 min in the group with the balloon and 63 min in the group without the balloon (p = 0.004). There was no difference between them in postoperative morbidity, and there were no major complications in either group. The recurrence rate was 3.1% in the group with the balloon and 3.7 % in the group without the balloon (p = 0.8). The use of a dissection balloon in TEP reduces the conversion rate and may be especially beneficial early in the learning curve.

Associated Clinical Trials

References

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Citations

Feb 16, 2005·Langenbeck's Archives of Surgery·B J LeiblR Bittner
Feb 2, 2006·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S BringmanT Heikkinen
Feb 4, 2011·Hernia : the Journal of Hernias and Abdominal Wall Surgery·N D Swadia
Oct 10, 2003·The Surgical Clinics of North America·Chad J Davis, Maurice E Arregui
Dec 25, 2012·Hernia : the Journal of Hernias and Abdominal Wall Surgery·J Daes
May 16, 2014·Langenbeck's Archives of Surgery·Stavros A AntoniouFrank A Granderath
Feb 13, 2008·The Surgical Clinics of North America·Mark C Takata, Quan-Yang Duh
Sep 14, 2007·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·M Z UllahS Jacob
May 29, 2019·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Asuri KrishnaSubodh Kumar
Jun 4, 2002·Nature Reviews. Genetics·Elizabeth A JoyceStanley Falkow
Feb 4, 2015·Hernia : the Journal of Hernias and Abdominal Wall Surgery·H TranW Hawthorne
Apr 23, 2013·Asian Journal of Endoscopic Surgery·Masaki WakasugiToshirou Nishida

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