Modified vs. Conventional Laparoscopic TAPP for Inguinal Hernia

N/ANot Yet RecruitingNCT07373314

University of Health Sciences Lahore60 enrolled

Overview

This study aims to compare the outcomes of two laparoscopic techniques for repairing inguinal hernias: the modified tumescent technique (MT-TAPP) and the conventional laparoscopic transabdominal preperitoneal technique (CL-TAPP). The primary goal is to determine which technique provides better outcomes in terms of operative time, ease of pre-peritoneal space dissection, postoperative pain, and the formation of seromas. The study will involve 60 patients diagnosed with unilateral inguinal hernias, randomly assigned to either group. Participants in Group A will undergo the MT-TAPP procedure, which involves pre-peritoneal infiltration of a local anesthetic solution to improve dissection and reduce pain. Group B will undergo the standard CL-TAPP procedure. Data will be collected on various outcome measures and analyzed to identify which technique leads to quicker recovery, less postoperative pain, and fewer complications. The results of this study will help guide surgical decisions and improve patient outcomes in inguinal hernia repair.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Inguinal Hernia Repair

Interventions

In this intervention, participants will undergo laparoscopic inguinal hernia repair using the modified tumescent technique. This technique involves pre-peritoneal infiltration of a solution containing lidocaine, epinephrine, and saline. The tumescent solution is injected into the peritoneum to create a "tumescent" effect, making the tissues easier to dissect and reducing bleeding. This approach aims to improve surgical visibility, reduce operative time, minimize postoperative pain, and shorten the learning curve for less experienced surgeons. The rest of the procedure follows the standard laparoscopic TAPP repair, with mesh placement and peritoneal closure.

Conventional Laparoscopic TAPP (CL-TAPP)OTHER

In this intervention, participants will undergo the conventional laparoscopic transabdominal preperitoneal (TAPP) hernia repair. This standard technique involves placing three ports to access the inguinal region, followed by dissection of the pre-peritoneal space and placement of a mesh to repair the hernia. The conventional method does not use tumescent infiltration and relies solely on the surgeon's skill to navigate the anatomical structures. This approach is well-established and commonly used in inguinal hernia repairs, but it may be associated with longer operative times and more postoperative pain compared to the modified technique.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age: 18 to 50 years. * Gender: Both male and female participants. * Condition: Diagnosed with unilateral inguinal hernia (as per operational definition). * Health Status: ASA I-III (American Society of Anesthesiologists physical status classification), indicating that the patient is fit for surgery. * Consent: Participants must be able to provide informed consent to participate in the study. Exclusion Criteria: * Femoral Hernias. * Incarcerated or Strangulated Hernia. * Recurrent Hernias (as per medical record). * Serious Systemic Diseases: * Conditions such as heart failure or coagulation problems (e.g., PT \> 15 sec). * ASA III-V classification, indicating a higher risk for surgery. * Pregnancy (if applicable). * Allergy to Anesthesia or the substances used in the tumescent solution (lidocaine, epinephrine, saline). * Uncontrolled Diabetes or other medical conditions that might interfere with the healing process.

Outcomes

Primary Outcomes

Pain Score

A score of 0 represents no pain, while a score of 10 represents the worst pain.

Time frame: Recorded 24 hours post-surgery.

Seroma Formation:

Time frame: Presence or absence of seroma, assessed during the 7-day postoperative follow-up.