Comparison of Early Postoperative Pain between Trans Abdominal Pre Peritoneal (TAPP) and Totally Extraperitoneal (TEP) techniques of Hernia Repair for Unilateral Inguinal Hernia : A Randomised Control Trial

Study will be performed at the Department of Surgery at Lady Hardinge Medical College. A written informed consent from all the patients included in study and institutional review board approval will be obtained for this study.

Patients will be interviewed and the full history of their condition will be taken. Thorough clinical examination will be done. All routine investigations LFT, KFT and USG will be done for this study. Each patient will be randomly allocated to the TAPP group or the TEP group by sequentially numbered, opaque, sealed envelope technique on the day of surgery. An independent statistician, who is not involved in patient care, will generate the randomisation sequence via a computer-generated random number. The randomisation code will be contained in opaque sealed envelopes. A non-acad junior resident, who will open the envelope, will not be actively involved in outcome measurements. Before randomisations and during consent, all patients will receive an explanation of the objectives of the study, techniques and complications associated with both the procedures. The patient will be unaware of the assigned group of treatment.

In the preoperative area, a single prophylactic dose of injection ceftriaxone 1 gm will be intravenously administered after the skin test. All procedures will be performed under GA with the patients in supine and Trendelenburg position as per the conventional three ports technique. The patients will be randomised into two groups: TAPP or TEP groups. Post-operatively, an injection of paracetamol 1 gram to be infused intravenously every 8 hours on the day of surgery in all patients of both groups. The additional analgesic requirement will be fulfilled by injection diclofenac 75 mg by the intravenous route, as needed if the visual analog scale (VAS) score will be more than three. As assessment of pain to be made using the VAS score in the postoperative period at 1 hour, 6 hours, 12 hours and 18 hours.