BALLOON DISSECTION VERSUS TELESCOPIC DISSECTION DURING LAPAROSCOPIC TOTALLY EXTRAPERITONEAL (TEP) INGUINAL HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Venkata S. Kolli*
General Surgery, Prince Charles Hospital, Merthyr Tydfil, Merthyr Tydfil, United Kingdom
Objectives:
To compare the outcomes of balloon dissection and telescopic dissection in patients undergoing laparoscopic totally extraperitoneal (TEP) inguinal hernia repair
Methods:
A systematic review in accordance with PRISMA statement standards was conducted. A search of electronic information sources was conducted to identify all studies comparing the outcomes of balloon dissection and telescopic dissection in patients undergoing laparoscopic TEP inguinal hernia repair. Random effects modelling was applied to calculate pooled outcome data.
Results:
A total of 800 patients from six studies were included. In terms of baseline characteristics, the included population in both groups were comparable in terms age (MD: 2.08 years, P=0.13), male gender (RD: 0.00, P=0.79), unilateral hernias (RD: 0.01, P=0.73), bilateral hernias (RD: -0.01, P=0.73), primary hernias (RD: -0.01, P=0.64), and bilateral hernias (RD: 0.01, P=0.64). The operative time was shorter in the balloon dissection group (MD:-4.88 minutes, P=0.03). There was no difference between the two techniques in terms of conversion to another technique (RD: -0.03, P=0.36), recurrence (RD: -0.00, P=0.87), haematoma (OR: 1.14, P=0.84), seroma (OR: 0.60, P=0.67), surgical site infection (RD: 0.00, P=0.90), urinary retention (OR: 0.81, P=0.76), postoperative pain score on day 1 (MD: -0.16, P=0.69), postoperative pain score on day 7 (MD: -0.16, P=0.61), postoperative pain score on day 30 (MD: 0.25, P=0.32), and time to return to normal activities (MD: -0.01, P=0.99).
Conclusions:
Balloon dissection and telescopic dissection during TEP inguinal hernia repair are comparable in terms of postoperative outcomes; balloon dissection may be associated with slightly shorter operative time.
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