Comparison of Laparoscopic Pre-Peritoneal Versus Retro-Muscular Mesh Hernioplasty for Simple Ventral Abdominal Wall Hernia: A Randomized Controlled Trial

Abstract

Objective: To compare perioperative and postoperative outcomes of laparoscopic transabdominal pre-peritoneal (TAPP) versus transabdominal retro-muscular (TARM) mesh hernioplasty for simple ventral abdominal wall hernia.

Study design: Randomized-controlled tria1

Study place and period: Surgical Unit, Ali Fatima Hospital, Lahore, from October 2025 to April 2026.

Methodology: Total 150 patients diagnosed with primary ventral abdominal wall hernias. Patients were random1y distributed into two groups. Group-I underwent laparoscopic TAPP. Group-II underwent laparoscopic TARM. Primary outcome measures included operative time, postoperative pain scores, wound infection, duration time to return to normal activities, and recurrence. Data analyses was done using SPSS v.26 with p-value ≤0.05 as significant.

Results: The mean age of patients was 46.25 ± 11.90 years in TAPP group and 48.03 ± 14.41 years in TARM group. In TAPP group, there were 31 (41.3%) males and 44 (58.7%) females. In TARM group, there were 26 (34.7%) males and 49 (65.3%) females. The mean operative time was significantly less with TARM (89.99±19.74 vs. 82.41±15.25) than TAPP, mean intraoperative blood loss was 73.67±14.77 vs. 62.87±11.26, mean time to return to daily activates was 11.48±2.35 vs. 8.85±2.14 days, Seroma formation (9.3% vs. 1.3%, p=0.063), hematoma formation (14.7% vs. 2.7%, p=0.17), wound infection rates (13.3% vs. 4%), and recurrence (8% vs. 0%) (p<0.05).

Conclusion: Both TAPP and TARM mesh hernioplasty are safe and effective ventral hernia repair methods. But the operative and postoperative parameters of TARM are better than TAPP and showed less wound-related complications.