Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;25(5):1309-1315.
doi: 10.1007/s10029-020-02361-w. Epub 2021 Jan 5.

Safety and efficacy in inguinal hernia repair: a retrospective study comparing TREPP, TEP and Lichtenstein (SETTLE)

J L Faessen  1 , J H M B Stoot  1 , R van Vugt  2
Affiliations

Safety and efficacy in inguinal hernia repair: a retrospective study comparing TREPP, TEP and Lichtenstein (SETTLE)

J L Faessen et al. Hernia. 2021 Oct.

Abstract

Background: This pilot trial investigates whether the trans rectus sheath extra-peritoneal (TREPP) mesh repair is a safe and effective procedure compared to the currently most performed inguinal hernia repair techniques TEP and Lichtenstein.

Methods: Three hundred patients older than 18 years with unilateral inguinal hernia were included in this retrospective cohort study, of which 58 (19.3%) underwent TREPP, 190 (63.3%) TEP and 52 (17.3%) Lichtenstein. The primary outcome of this study was inguinal hernia recurrence rate within 1 year after surgery. Secondary objectives were chronic post-operative inguinal pain (CPIP) lasting more than 6 months, (major) complication rates and operating time.

Results: Recurrence rate within 1-year post-operative was low overall in the study population and did not differ significantly between TREPP, TEP and Lichtenstein, respectively 1.7, 2.1, 0.0% (P = 0.591). The rate of CPIP for which the patient contacted the hospital was similar in the study groups: TREPP: 1.7%; TEP: 1.6%; Lichtenstein: 1.9%; (P = 0.591). The mean operating time in minutes (SD) was significantly shorter in the TREPP group compared with the two other patient groups (TREPP: 22.2 (± 5.7); TEP: 38.7 (± 14.8); Lichtenstein: 49.3 (± 17.1), P < 0.001). No major complications occurred in any patient of the study groups.

Conclusion: TREPP seems to be an effective and safe technique for unilateral primary inguinal hernia repair. It is found to be comparable to TEP and Lichtenstein in terms of recurrence rates, chronic post-operative inguinal pain, and clinically significant adverse events. This pilot study proves the need for future research into the TREPP technique.

Keywords: Extraperitoneal; Hernia; Herniorrhaphy; Inguinal; Lichtenstein; TEP; TREPP.

PubMed Disclaimer

References

    1. Dutch Society for Surgery (NVvH) (2019) Official Dutch Inguinal Hernia Guideline: Liesbreuk bij volwassenen. Dutch federation of medical specialists. https://richtlijnendatabase.nl/richtlijn/liesbreuk_bij_volwassenen
    1. HerniaSurge G (2018) International guidelines for groin hernia management. Hernia 22(1):1–165 - DOI
    1. McCormack K et al (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001785 - DOI - PubMed - PMC
    1. Charalambous MP, Charalambous CP (2018) Incidence of chronic groin pain following open mesh inguinal hernia repair, and effect of elective division of the ilioinguinal nerve: meta-analysis of randomized controlled trials. Hernia 22(3):401–409 - DOI
    1. Erhan Y et al (2008) Chronic pain after Lichtenstein and preperitoneal (posterior) hernia repair. Can J Surg 51(5):383–387 - PubMed - PMC

LinkOut - more resources