The Comparison of Balloon and Camera Dissection of the Preperitoneal Space in Totally Extraperitoneal Repair Hernia Repair. Our Initial Experience!

Abstract

Purpose. To perform totally extraperitoneal repair of a hernia, it is essential to create a working space for the placement of instruments. In this study, we aimed to compare balloon dissection (BD) and camera or telescopic dissection (CD) with respect to the surgical outcomes, without considering the cost-effectiveness. Methods. Forty consecutive, healthy, unilateral inguinal hernia patients who underwent Totally Extraperitoneal Repair hernia repair were randomized into 2 groups according to whether they received BD or CD. The perioperative demographic characteristics were recorded. All the operations were video recorded from the beginning to the end of each procedure. The virtually constructed periods of the procedures were evaluated by another surgeon who watched each video. The time spent for each period, the severity score assigned by the surgeon, the total operation time, the peritoneal laceration rate, the presence of early and late postoperative pain, the number of postoperative visits, the total analgesic requirements, and the complications were recorded. Results. The demographic properties of the patients, the perioperative and postoperative complications, and the severity scores in the BD and CD groups were statistically similar. The total operating time and the time from the dissection of the peritoneum to the reduction of the hernia sac were significantly longer in the CD group. Post-discharge analgesic consumption, Visual Analog Scale scores, and the number of visits were similar between the groups. Conclusions. The dissection of the working space in the preperitoneal area can be achieved using camera dissection without the risk of common complications associated with balloon dissection, particularly balloon rupture.