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Comparison of extended totally extra peritoneal (eTEP) vs intra peritoneal onlay mesh (IPOM) repair for management of primary and incisional hernia in terms of early outcomes and cost effectiveness—a randomized controlled trial

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Abstract

Background

There are no randomized controlled trials comparing the eTEP with IPOM repair and this randomized study was designed to compare the two techniques in terms of early pain, cost effectiveness, and quality of life.

Method

This was a prospective randomized trial with intention to treat analysis. The primary outcome was immediate post-operative pain scores. Operative time, conversions, peri operative morbidity, hospital stay, return to daily activities, incremental cost effectiveness ratio and quality of life (WHO-QOL BREF) were secondary outcomes.

Results

Sixty patients were randomized equally. Early post-operative pain scores and seroma rates were significantly lower and with a significantly earlier return to activity in eTEP group (p value < 0.05). With negative costs and positive effects, eTEP group was 2.4 times more cost effective.

Conclusion

eTEP repair is better in terms of lesser early post-operative pain, earlier return to activities and cost effectiveness in small and medium size defects.

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Authors and Affiliations

  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5026A, 5th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029, India

    Mayank Jain, Asuri Krishna, Om Prakash, Subodh Kumar & Virinder Kumar Bansal

  2. Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

    Rajesh Sagar

  3. Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India

    Rashmi Ramachandran

Authors
  1. Mayank Jain
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  2. Asuri Krishna
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  3. Om Prakash
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  4. Subodh Kumar
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  5. Rajesh Sagar
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  6. Rashmi Ramachandran
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  7. Virinder Kumar Bansal
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Corresponding authors

Correspondence to Asuri Krishna or Virinder Kumar Bansal.

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Disclosures

Dr. Mayank Jain,Dr. Asuri Krishna, Dr. Om Prakash, Dr. Subodh Kumar, Dr. Rajesh Sagar, Dr. Rashmi Ramachandran and Dr. Virinder Kumar Bansal have no conflicts of interest or financial ties to disclose.

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Jain, M., Krishna, A., Prakash, O. et al. Comparison of extended totally extra peritoneal (eTEP) vs intra peritoneal onlay mesh (IPOM) repair for management of primary and incisional hernia in terms of early outcomes and cost effectiveness—a randomized controlled trial. Surg Endosc 36, 7494–7502 (2022). https://doi.org/10.1007/s00464-022-09180-3

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  • DOI: https://doi.org/10.1007/s00464-022-09180-3

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