Evidenz - Leistenhernienreparation, transabdominelle präperitoneale Hernioplastik (TAPP)

Die operative Versorgung einer Leistenhernie (uni- oder bilateral) in TAPP-Technik bietet gegenüber der offenen Lichtenstein-Technik beim Erwachsenen folgende Unterschiede:

• geringfügig niedrigere Rezidivraten
• üblicherweise eine etwas längere Operationszeit
• wohl ähnliche postoperative Schmerzen, aber etwas seltener chronische Schmerzen 
• schnellere Rekonvaleszenz 
• üblicherweise höhere Krankenhauskosten, aber wohl niedrigere volkswirtschaftliche Gesamtkosten 

Im Vergleich zur Shouldice-Operation wurden folgende Effekte belegt:

• etwas weniger Hernienrezidive
• üblicherweise eine etwas längere Operationszeit 
• etwas geringere postoperative Schmerzen
• schnellere Rekonvaleszenz
• etwas weniger Nervenläsionen und chronische Schmerzen

Gegenüber der total extraperitonealen Technik (TEP) erlaubt die TAPP laut der bisherigen Datenlage:

• etwas kürzere Operationszeiten
• ähnliche Rezidivraten und Schmerzintensitäten

Zur Netzfixierung mit Staplern im Vergleich zu keiner Fixierung fand eine Studie bei der TAPP:

• ähnliche Rezidivraten
• ähnliche Raten chronischer Schmerzen

The use of local anaesthetic in laparoscopic inguinal hernia repair: a randomised clinical trial

QOL in Incarcerated Inguinal Hernias: TAPP Vs Open Repair

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