First experience with laparoscopic totally extraperitoneal herniorrhaphy: a comparison before and after overcoming the learning curve

Purpose: Laparoscopic totally extraperitoneal (TEP) herniorrhaphy is one of the leading methods for inguinal hernia repair methods.This study aimed to investigate the safety and feasibility of laparoscopic TEP herniorrhaphy performed by a single surgeon.Materials and Methods: A retrospective review was conducted between January 2017 and July 2022 to analyze the medical records of patients with inguinal hernia who underwent laparoscopic TEP herniorrhaphy.Operative outcomes and complications were compared by dividing the cases into 2 groups of 100 consecutive procedures (Group A: before overcoming the learning curve, n=100; Group B: after overcoming the learning curve, n=100).Results: The mean operative time for Group B was significantly reduced compared to that for Group A (59.0 ± 13.1 vs. 45.2 ± 15.4 minutes; P=0.02).A statistically significant difference was also found in conversion to other methods (3 vs. 0 cases, P=0.03) between the 2 groups.There were 3 and one cases of recurrence in the 2 groups, respectively (P=0.14).Conclusions: Experience with 100 TEP herniorrhaphies was associated with a significant reduction in operative time.