Muhammad Asadullah, Mansab Ali, Amir Usman.
TAPP Repair of Inguinal Hernia: Learning Curve and Complications in a General Hospital.
Pak J Med Health Sci Jan ;12(3):1002-4.

Aim: To study our experience TAPP repair of inguinal hernia in surgeons who have started this procedure from the very beginning independently and outcome regarding postoperative complications in TAPP repair of inguinal hernias especially comparing the use of absorbable tackers in one group and non-absorbable tackers in another group. Methods: We described our standard TAPP technique and evaluated the results of post-operative outcome regarding pain and complications. Results: We retrospectively reviewed our surgical unit experience of TAPP; we included in our study 63 patients. The sample was divided into two groups: TAPP using absorbable tackers and TAPP using non-absorbable tackers. The group in which absorbable tackers were used are 44 in number and group with non-absorbable tackers were 19 in number. Mean follow up for patients was 12 months regarding post-operative complications. The recurrence rate was up to 5.2% in all patients. That high rate is the cause of early learning curve of the operating surgeon and improper mesh fixation. There was no major vascular butone case of small bowel injury which later died in due course of treatment of this complication. Mean operative time was average of 91 minutes. Postoperative pain in group in which non-absorbable tackers were used was not significantly higher than group with absorbable tackers. Recurrence was reported in 3 cases and all were within third week of surgery. Conclusion: In our experience TAPP procedure is safe and feasible procedure and there is a significant difference in postoperative pain when non-absorbable tackers are used, and post-operative complications in the early phase of learning curve do happen and its advisable to go through this phase under supervision of experienced surgeon over a period of at-least one year.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com