ORIGINAL ARTICLE   

Minerva Chirurgica 2017 October;72(5):365-7

DOI: 10.23736/S0026-4733.17.07379-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

If time matters: a multicenter review of minimally-invasive hernia repair in 7176 cases

Kai WITZEL ^{1, 2} ✉, Michael WEITZENDORFER ¹

¹ Department of Surgery, Paracelsus Medical University, Salzburg, Austria; ² Minimally Invasive Center, Hünfeld, Germany

BACKGROUND: In endoscopic hernia repair totally extraperitoneal approach (TEP) and transabdominal preperitoneal approach (TAPP) are seen as equivalent surgical techniques in quality, but not in procedure-time.
METHODS: We compared the two most common procedures in endoscopic hernia surgery. Focusing on the duration of the surgical procedure, we analyzed 7176 endoscopic hernia operations in 25 hospitals retrospectively and compared it to the literature.
RESULTS: In our study TEP (N.=2799) took on average 59 minutes, TAPP (N.=4377) took 67.5 minutes, thus with a significant difference (P=0.043). In high volume centres this difference was even bigger. As there are few consistent advantages of one of the procedures in general, the procedure’ s duration becomes more important.
CONCLUSIONS: If time is the main reason, the TEP procedure takes on average 8.5 minutes less time, so it can be more cost-effective.

KEY WORDS: Endoscopy - Herniorrhaphy - Cost-benefit analysis