If time matters: a multicenter review of minimally-invasive hernia repair in 7176 cases.

BACKGROUND: In endoscopic hernia repair totally extraperitoneal approach (TEP) and transabdominal preperitoneal approach (TAPP) are seen as equivalent surgical techniques in quality, but not in procedure-time.

METHODS: We compared the two most common procedures in endoscopic hernia surgery. Focusing on the duration of the surgical procedure, we analyzed 7176 endoscopic hernia operations in 25 hospitals retrospectively and compared it to the literature.

RESULTS: In our study TEP (N.=2799) took on average 59 minutes, TAPP (N.=4377) took 67.5 minutes, thus with a significant difference (P=0.043). In high volume centres this difference was even bigger. As there are few consistent advantages of one of the procedures in general, the procedure' s duration becomes more important.

CONCLUSIONS: If time is the main reason, the TEP procedure takes on average 8.5 minutes less time, so it can be more cost-effective.