In this study, researchers compared the advantages and disadvantages of GA and spinal anesthesia (SA) in TEP operations. To compare TEP inguinal hernia repair performed when the patient was treated under spinal anesthesia (SA) with that performed under general anesthesia (GA). Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is an effective and safe method for the treatment of inguinal hernia.
Inguinal hernia repair is one of the most commonly performed elective surgical procedures in the world. But, there is no common consensus on which surgical technique should be used. Hernia recurrence, wound infection, scrotal edema, bleeding and chronic pain are the complications that disturb surgeons in the postoperative period.
Many techniques have been described from the first inguinal hernia repair until today. After laparoscopic techniques were introduced in surgery, a new era began for hernia repair. However, with the emergence of minimally invasive approaches to inguinal hernia repair, a new discussion has since been started, regarding “the best hernia repair.
Laparoscopic techniques offer some advantages, such as less pain, less analgesic requirement, lower wound infection rate, better cosmetic result and early return to work, in the early postoperative period. Studies continue to find the best method for inguinal hernia repair. Tension-free hernia repair was the best technique for inguinal hernia repair before laparoscopic techniques were introduced to surgery.
Randomized clinical trials have shown that TEP provides better cosmetic results, less pain, less analgesic requirement and early return to work in the postoperative period compared to open hernia repair. Regional anesthesia, which is commonly used in open hernia repair, is not preferred by surgeons and anesthesiologists during laparoscopic operations.
The reasons why surgeons do not prefer it are that patients have a fear of needles applied to their waist and request complete analgesia, the learning curve and training are easier in GA, and the surgeons believe that adequate muscle relaxation cannot be achieved. However, when the peritoneum is opened.
In giant scrotal hernia and recurrent hernia cases and in cases where the hernia sac cannot be separated from the cord, the patient feels pain, due to gas escaping into the abdominal cavity. Spinal anesthesia is superior in terms of hypotension, vomiting, and pain development in the early postoperative period, when compared with GA.
Another advantage of SA is that patients can follow the surgery on the monitor because they are awake. In conclusion, a total extraperitoneal surgery performed under SA provides adequate muscle relaxation and a suitable work environment, as seen under GA. It also protects the patient from possible risks of GA.
From the results obtained in our study, TEP operations performed under SA are safe, effective and satisfactory in terms of patient comfort.