Page 19 - World Journal of Laparoscopic Surgeons

Utpal De, Pronoy Kabiraj
Table 2: Multivariate analysis of anthropometric parameters of the patients
Type of surgery No. Mean SD “t”/M-W-U test (p-value)
BMI TEP 33 19.400909 0.7792960 0.000* (<0.001)
TAPP 12 22.530000 0.3529615
ASIS–ASIS TEP 33 24.221 0.7897 23.000* (<0.001)
TAPP 12 22.875 0.2379
U–ASIS TEP 33 15.463636 0.7175558 14.000* (<0.001)
TAPP 12 14.000000 0.1705606
U–SP TEP 33 15.684848 0.3977446 8.983 (<0.001)
TAPP 12 14.508333 0.3604501
SP–ASIS TEP 33 14.982 0.6989 63.500* (0.001)
TAPP 12 14.158 0.3288
FAT PAD TEP 33 1.791 0.1974 −13.371 (<0.001)
TAPP 12 2.775 0.2701
*Mann–Whitney U test done; M-W-U: Mann–Whitney U test; FAT PAD: fat pad thickness

Endoscopic hernia repair is another armamentarium working space, better visualization, and greater freedom
in this gallery of hernia repair. Though the technical of movement.
2,5
procedure is the same, the approach is different. More- The other outcome from our study was that TEP
over, the anatomy, working space, surgeon’s capability, should be the initial procedure to start with as failure
learning curve, cost-effectiveness, complications, recur- still does not preclude the patient from TAPP, whereas
rence, and overall patients’ demand, satisfaction and failure in TAPP leaves the patients with the only option
acceptability 1-6,8 have placed hernia surgeons in peculiar for open hernia repair.
dilemma never seen before. General surgeons perform- Our results are also consistent with other studies as
ing hernia surgery in an attempt to master endoscopic regards intraoperative complications, cost effectiveness,
repair grope hard to adhere to one or the other procedure postoperative outcome, and patient satisfaction. 1-8
based purely on evidences laid by surgeons practicing a To conclude, we can say that PIA could be helpful for
particular procedure rather than appreciating the techni- defining patients undergoing endoscopic hernia repair,
cal details which would suit them. As endoscopic hernia though a larger series with more number of patients is
surgery is ergonomically driven, a particular procedure warranted. There should be no graduation parameters
suitable and comfortable to one surgeon might not be of adapting from one procedure to another and it is up
compatible with the other. As such, the issue of learn- to the operating surgeon to decide which procedure is
3-6
ing curve for a particular procedure before promoting ergonomically beneficial to him or her.
oneself to another procedure does not hold true. Rather,
mastering one technique which ergonomically suits a REFERENCES
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