Telescopic Dissection Versus Gauze Dissection for Creation of Extra Peritoneal Space During Laparoscopic Totally Extra Peritoneal Inguinal Hernia Repair

Background: Inguinal hernia is a common surgical condition. TEP repair offers faster recovery but requires challenging preperitoneal space creation. Gauze and telescopic dissection are low-cost alternatives whose safety and effectiveness require comparative evaluation. The study compared gauze and telescopic dissection for extraperitoneal space creation in TEP inguinal hernia repair, assessing operative time, bleeding, pain, complications, recurrence, and outcomes. Material and Methods: The present study was a Prospective comparative interventional study. This Study was conducted from March 2020 to August 2021. Department of General Surgery, Bankura Sammilani Medical College and Hospital. Study population 60.  Results: Among 60 male patients (30 per group), the mean age was comparable between the gauze and telescopic groups (47.33 ± 13.28 vs. 45.73 ± 12.36 years; p=0.6309). Peritoneal breach occurred in 23.3% and 46.7% patients, respectively (p=0.0581). The gauze group had significantly lower intraoperative bleeding (13.47 ± 7.20 vs. 18.40 ± 9.33 ml; p=0.0254), shorter operative time (58.83 ± 20.83 vs. 77.67 ± 24.90 min; p=0.0024), and lower pain scores on day 1 (4.93 vs. 5.47; p=0.0150) and day 7 (1.63 vs. 2.60; p=0.0001). Return to work was similar (13.10 vs. 14.07 days; p=0.2660). Conclusion: Both gauze and telescopic dissection were safe and effective for TEP inguinal hernia repair; however, gauze dissection provided shorter operative time, reduced intraoperative bleeding, and lower early postoperative pain with comparable complication rates.

Keywords: Inguinal hernia, Laparoscopic totally extraperitoneal repair (TEP), Telescopic dissection, Gauze dissection, Preperitoneal space creation, Operative time, Intraoperative bleeding, Postoperative pain, Peritoneal breach, Surgical outcomes.