Introduction: Transabdominal preperitoneal approach (cTAPP) is effective method in treatment of inguinal hernia. Technical difficulties and long learning curve are the main disadvantages. We suggest that tumescent injection in
the preperitoneal space during TAPP before dissection may facilitate technical difficulties and decrease the learning
curve with subsequent improvement of the competence of the trainee to do the surgery.
Patients and methods: From March 2020 to March 2022, our study enrolled 200 patients, evenly split between
those receiving conventional TAPP (cTAPP) and Tumescent TAPP (tTAPP). The surgeries were performed by
trainees under supervision. The surgical procedure involved injecting a mixture of 50 ml of 0.5% Bupivacaine and
adrenaline diluted to 1 in 200,000 into the extraperitoneal space. The rest of the operation was consistent with the
conventional techniques of TAPP repair.
Results: There was a highly significant difference between both study groups as regards operative time with
higher mean time among cTAPP cases. There was a highly significant difference between both study groups
as regards pain score 24 hours after operation with higher mean time among cTAPP cases. Yet, no significant
difference was found in pain score 2 weeks, 30 days and 1 year after operation. Regarding the competence and
learning of the trainees, there was significant difference in overall competence with favor to tTAPP group.
Conclusion: The application of Tumescent technique in TAPP surgery could potentially reduce the learning curve,
abbreviate the duration of the operation, and alleviate postoperative discomfort for patients when contrasted with
the traditional TAPP method.