Trial reportHernia : the journal of hernias and abdominal wall surgery2013
Selecting patients during the "learning curve" of endoscopic Totally Extraperitoneal (TEP) hernia repair.
Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Surgeon experience and patient selection influence the learning curve in robotic inguinal hernia repair.Journal of robotic surgery · 2025Article
- The mentoring effects of learning curve of total extraperitoneal hernioplasty: the CUSUM analysis of the pioneer and second-generation surgeon.Surgical endoscopy · 2025Article
- The learning curve of laparoscopic inguinal hernia repair: a comparison of three inexperienced surgeons.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021Article
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- Article
- Learning curve takes 65 repetitions of totally extraperitoneal laparoscopy on inguinal hernias for reduction of operating time and complications.Surgical endoscopy · 2017Article
- Total Extraperitoneal Hernia Repair: Residency Teaching Program and Outcome Evaluation.World journal of surgery · 2017Article
- Combined open and laparoscopic technique for extraperitoneal mesh repair of large sac inguinal hernias.Surgical endoscopy · 2016Article
- Totally extraperitoneal (TEP) endoscopic hernia repair in elderly patients.Hernia : the journal of hernias and abdominal wall surgery · 2015Article
- Factors influencing on difficulty with laparoscopic total extraperitoneal repair according to learning period.Annals of surgical treatment and research · 2014Article
- A New Proposal for Learning Curve of TEP Inguinal Hernia Repair: Ability to Complete Operation Endoscopically as a First Phase of Learning Curve.Minimally invasive surgery · 2014Article
- IMPACT OF OBESITY AND SURGICAL SKILLS IN LAPAROSCOPIC TOTALLY EXTRAPERITONEAL HERNIOPLASTY.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgeryArticle
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Authors and funding
10 authors.
Funding
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Abstract
backgroundTotally Extraperitoneal (TEP) hernia surgery is associated with little postoperative pain and a fast recovery, but is a technically demanding operative procedure. Apart from the surgeon's expertise, patient characteristics and hernia-related variations may also affect the operative time and outcome.
methodsPatient-related factors predictive of perioperative complications, conversion to open anterior repair, and operative time were studied in a cohort of consecutive patients undergoing TEP hernia repair from 2005 to 2009.
resultsA total of 3,432 patients underwent TEP. The mean operative time was 26 min (SD ± 10.9), TEP was converted into an open anterior approach in 26 patients (0.8 %), and perioperative complications were observed in 55 (1.6 %) patients. Multivariable regression analysis showed that a history of abdominal surgery (OR 1.76, 95 per cent confidence interval 1.01-3.06; p = 0.05), and the presence of a scrotal (OR 5.31, 1.20-23.43; p = 0.03) or bilateral hernia (OR 2.25, 1.25-4.06; p = 0.01) were independent predictive factors of perioperative complications. Female gender (OR 5.30. 1.52-18.45; p = 0.01), a history of abdominal surgery (OR 3.96, 1.72- 9.12; p = 0.001), and the presence of a scrotal hernia (OR 34.84, 10.42-116.51, p < 0.001) were predictive factors for conversion. A BMI ≥ 25 (effect size (ES) 1.78, 95 % confidence interval 1.09-2.47; p < 0.001) and the presence of a scrotal (ES 5.81, 1.93-9.68; p = 0.003), indirect (ES 2.78, 2.05- 3.50, p < 0.001) or bilateral hernia (ES 10.19, 9.20-11.08; p < 0.001) were associated with a longer operative time.
conclusionCertain patient characteristics are, even in experienced TEP surgeons, associated with an increased risk of conversion and complications and a longer operative time. For the surgeon gaining experience with TEP, it seems advisable to select relatively young and slender male patients with a unilateral (non-scrotal) hernia and no previous abdominal surgery to enhance patient safety and 'surgeon comfort'.
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