Ultrasonic energy device versus monopolar energy device in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair

Abstract

Laparoscopic transabdominal preperitoneal (TAPP) is gaining popularity as an approach to repairing of inguinal hernia. In many institutions, a disposable ultrasonic energy device is used in the TAPP repair procedure. However, the benefit and necessity of an ultrasonic device are unclear. We have switched to use of a reusable monopolar energy device, and we conducted a retrospective study comparing the surgical results obtained with each of the energy devices. Our study group comprised 241 adults who underwent TAPP repair for inguinal hernia between November 2012 and December 2014. We compared clinical characteristics, and surgical outcomes between patients in whom a disposable ultrasonic energy device was used (n = 116, U group) and those in whom a reusable monopolar energy device (n = 125, M group) was used. There was no statistically significant difference between the 2 groups in age, sex, body mass index, or hernia type. In cases of unilateral hernia, operation time was significantly longer in the U group than in the M group (71.4 vs. 59.4 min, respectively, p < 0.001). No significant difference was found in intraoperative blood loss (2.3 vs 3.9 ml, p = 0.329), postoperative morbidity (5.2 vs 4.0%, p = 0.663), or postoperative hospital stay (2.1 vs 2.2 days, p = 0.336). Our experience and increased competence with the monopolar energy device lead us to conclude that the ultrasonic energy device is unnecessary for simple TAPP repair.

Keywords: Cost effective; Monopolar energy; TAPP; Ultrasonic energy.