Totally Extraperitoneal (TEP) versus Transabdominal Preperitoneal (TAPP) Repair for Inguinal Hernia: A Prospective Comparative Study

Context: Laparoscopic inguinal hernioplasty is commonly performed as TEP or TAPP, but comparative advantages remain debated. Aims: To compare operative time, early pain, peri-operative complications, hospital stay and short-term recurrence between TEP and TAPP. Settings and Design: Prospective observational study at a tertiary-care teaching hospital (March 2023–June 2024) with six-month follow-up. Methods and Material: Fifty adult males with primary inguinal hernia were enrolled and allocated to TEP (n=25) or TAPP (n=25). Inclusion/exclusion criteria were predefined; Primary outcomes were POD-1 pain (VAS 0–10) and recurrence; secondary outcomes included operative time, intra-operative vascular injury, seroma, haematoma, port-site infection, surgical emphysema, and length of stay. Assessments were done at 24 h, day 10, three months, and six months. Statistical analysis used: Continuous variables were compared with unpaired ttest; categorical variables with odds ratio/Z and p-values (MedCalc). Results: Mean age was similar between groups. TEP had shorter operative time, lower POD-1 pain, and shorter hospital stay compared with TAPP. Complications were infrequent and comparable between groups. Recurrence at six months was observed in one TEP case and none in TAPP. Conclusions: In the early postoperative period, TEP was associated with less pain, shorter operative time, and shorter hospital stay, with similar complication and short-term recurrence rates compared with TAPP. Larger randomised trials with longer follow-up are warranted.