Establishment of Laparoscopic Inguinal Repair at a Swedish Tertiary Center: Peri-Operative Data, Recurrence and Patient-Reported Outcome Between 2015 and 2020

Abstract Background TAPP was introduced in Sundsvall County Hospital, Sweden in late 2014. The results of either open tension-free mesh technique or TAPP consecutively performed between 2015 and 2020 was studied. Methods 650 consecutive patients were studied retrospectively with prospectively collected data from Swedish Hernia Registry. Patient demographics, peri-operative data, recurrence and patient reported outcome were studied. Results 231 TAPP and 419 open procedures were performed for 588 (90,5%) primary hernias and 62 (9,5%) recurrent hernias. 598 (92,0%) repairs were elective and 555 (85,4%) were treated in day care. Mean operation time for a TAPP was 48,7 minutes (SD 21,7) and for open repair 75,8 minutes (SD 27,8), p 0.05. Repair of recurrent- and bilateral hernia were more common with a TAPP (p 0.001). Of 219 operations performed by residents, 204 (93,2%) were open repairs and 15 (6,8%) TAPP (p 0.001). Postoperative complications occurred in 29 (4,5%) cases, of which 21 after open repair (p 0.05). Surgeon's competence was not associated with postoperative complications. Recurrence occurred in 2 (0,9%) TAPP and in 5 (1,2%) open repairs, the differences not significant. Conclusion Despite reflecting results from the department´s learning curve, TAPP was faster and produced comparable low rates of complications and recurrence as those from open repair. More than half of the inguinal hernia repairs were performed by specialists in surgery.