E-ISSN 2367-699X | ISSN 2367-7414
 

Original Research 


Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair

Sarvesh Maheshwari, Neelkamal Gupta, Saurabh Jagtap, Brijesh Kumar Sharma.

Abstract
Background: A hernia surgery can be performed via the classical open technique, or laparoscopically. However, the later techniques viz. total extraperitoneal repair and transabdominal pre-peritoneal techniques are allied to a steep learning curve.
Aim and Objectives: In this study, we aim to define the learning curve associated with a TEP inguinal hernia repair.
Materials and Methods: We conducted a prospective study, of 125 patients with inguinal hernia posted for laparoscopic inguinal hernia repair by a total extra peritoneal technique, to assess the learning curve. Two surgeons: surgeon 1 (assessee, junior surgeon) and surgeon 2 (assessor, senior surgeon) were chosen. The learning curve was assessed for surgeon 1, who was a general laparoscopic surgeon, not performing laparoscopic hernia repair, while surgeon 2 was regularly performing laparoscopic hernia repairs. The study period was between January 2018 and January 2022. A direct comparison was made, based on operative time, peritoneal laceration, vascular injury, conversion rates, hospital stay and complications.
Results: Out of 125 patients, 50 patients were operated by the surgeon 1 and 75 were operated by surgeon 2. Mean operating time by surgeon 2 was 52 ± 4.5 minutes, and 66 ± 4.18 minutes for surgeon 1 with a p value of 0.0005. This was the only statistically significant variable, while surgical complications like peritoneal laceration, vascular injury or conversions to TAPP were statistically insignificant.
Conclusion: Surgeon 1 (Assessee) required to perform 10 TEP surgeries to overcome the learning curve. Therefore, surgeons with a prior experience in laparoscopic surgery needs a shorter learning curve as compared to a beginner in laparoscopic surgery, when it comes to laparoendoscopic groin hernia repair.

Key words: Total Extraperitoneal, Hernia, Repair, Learning curve, Difficult, experience


 
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How to Cite this Article
Pubmed Style

Maheshwari S, Gupta N, Jagtap S, Sharma BK. Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. Int J Surg Med. 2022; 8(6): 23-26. doi:10.5455/ijsm.136-1643736509


Web Style

Maheshwari S, Gupta N, Jagtap S, Sharma BK. Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. https://www.ejos.org/?mno=23631 [Access: January 11, 2023]. doi:10.5455/ijsm.136-1643736509


AMA (American Medical Association) Style

Maheshwari S, Gupta N, Jagtap S, Sharma BK. Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. Int J Surg Med. 2022; 8(6): 23-26. doi:10.5455/ijsm.136-1643736509



Vancouver/ICMJE Style

Maheshwari S, Gupta N, Jagtap S, Sharma BK. Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. Int J Surg Med. (2022), [cited January 11, 2023]; 8(6): 23-26. doi:10.5455/ijsm.136-1643736509



Harvard Style

Maheshwari, S., Gupta, . N., Jagtap, . S. & Sharma, . B. K. (2022) Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. Int J Surg Med, 8 (6), 23-26. doi:10.5455/ijsm.136-1643736509



Turabian Style

Maheshwari, Sarvesh, Neelkamal Gupta, Saurabh Jagtap, and Brijesh Kumar Sharma. 2022. Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. International Journal of Surgery and Medicine, 8 (6), 23-26. doi:10.5455/ijsm.136-1643736509



Chicago Style

Maheshwari, Sarvesh, Neelkamal Gupta, Saurabh Jagtap, and Brijesh Kumar Sharma. "Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair." International Journal of Surgery and Medicine 8 (2022), 23-26. doi:10.5455/ijsm.136-1643736509



MLA (The Modern Language Association) Style

Maheshwari, Sarvesh, Neelkamal Gupta, Saurabh Jagtap, and Brijesh Kumar Sharma. "Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair." International Journal of Surgery and Medicine 8.6 (2022), 23-26. Print. doi:10.5455/ijsm.136-1643736509



APA (American Psychological Association) Style

Maheshwari, S., Gupta, . N., Jagtap, . S. & Sharma, . B. K. (2022) Outcomes and Learning Curve in Total Extra Peritoneal Hernia repair. International Journal of Surgery and Medicine, 8 (6), 23-26. doi:10.5455/ijsm.136-1643736509