Abstract
Laparoscopic transabdominal preperitoneal (TAPP) is gaining popularity as an approach to repairing of inguinal hernia. In many institutions, a disposable ultrasonic energy device is used in the TAPP repair procedure. However, the benefit and necessity of an ultrasonic device are unclear. We have switched to use of a reusable monopolar energy device, and we conducted a retrospective study comparing the surgical results obtained with each of the energy devices. Our study group comprised 241 adults who underwent TAPP repair for inguinal hernia between November 2012 and December 2014. We compared clinical characteristics, and surgical outcomes between patients in whom a disposable ultrasonic energy device was used (n = 116, U group) and those in whom a reusable monopolar energy device (n = 125, M group) was used. There was no statistically significant difference between the 2 groups in age, sex, body mass index, or hernia type. In cases of unilateral hernia, operation time was significantly longer in the U group than in the M group (71.4 vs. 59.4 min, respectively, p < 0.001). No significant difference was found in intraoperative blood loss (2.3 vs 3.9 ml, p = 0.329), postoperative morbidity (5.2 vs 4.0%, p = 0.663), or postoperative hospital stay (2.1 vs 2.2 days, p = 0.336). Our experience and increased competence with the monopolar energy device lead us to conclude that the ultrasonic energy device is unnecessary for simple TAPP repair.
Similar content being viewed by others
References
Ger R, Monroe K, Duvivier R et al (1990) Management of indirect inguinal hernias by laparoscopic closure of the neck of the sac. Am J Surg 159:370–373
Popp LW (1990) Endoscopic patch repair of inguinal hernia in a female patient. Surg Endosc 4:10–12
Schultz L, Graber J, Pietrafitta J et al (1990) Laser laparoscopic herniorrhaphy: a clinical trial preliminary results. J Laparoendosc Surg 1:41–45
Cengiz Y, Janes A, Grehn A et al (2005) Randomized trial of traditional dissection with electrocautery versus. ultrasonic fundus-first dissection in patients undergoing laparoscopic cholecystectomy. Br J Surg 92:810–813
Zhou BJ, Song WQ, Yan QH et al (2008) Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer. World J Gastroenterol 14:4065–4069
Wilhelm D, Szabo M, Glass F et al (2011) Randomized controlled trial of ultrasonic dissection versus standard surgical technique in open left hemicolectomy or total gastrectomy. Br J Surg 98:220–227
Mahabaleshwar V, Kaman L, Iqbal J et al (2012) Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial. Can J Surg 55:307–311
Suzuki Y, Okano K, Kuroda Y (2015) Ultrasonic dissection versus conventional dissection techniques in pancreatic surgery: a randomized multicentre study. Ann Surg. doi:10.1097/SLA.0000000000000389
Zanghi A, Cavallaro A, Di Mattia P et al (2014) Laparoscopic cholecystectomy: ultrasonic energy versus monopolar electrosurgical energy. Eur Rev Med Pharmacol Sci 18:54–59
Gass M, Banz VM, Rosella L et al (2012) TAPP or TEP? Population-based analysis of prospective data on 4,552 patients undergoing endoscopic inguinal hernia repair. World J Surg 36:2782–2786
Morino M, Rimonda R, Allaix ME et al (2005) Ultrasonic versus standard electric dissection in laparoscopic colorectal surgery: a prospective randomized clinical trial. Ann Surg 242:897–901 (discussion 901)
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Research involving human participants and/or animals
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent
For this type of study formal consent is not required.
Rights and permissions
About this article
Cite this article
Otsuka, S., Kaneoka, Y., Maeda, A. et al. Ultrasonic energy device versus monopolar energy device in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. Updates Surg 69, 55–60 (2017). https://doi.org/10.1007/s13304-016-0412-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-016-0412-x