Needle Orientation & Closure Direction in TAPP Hernia Repair

Background

Laparoscopic transabdominal preperitoneal (TAPP) repair is a widely used minimally invasive technique for inguinal-hernia management, and reconstruction of the peritoneal flap is a key step whose technical details may affect closure time and surgeon effort. This collaborator-led, prospective randomised controlled trial protocol, titled “Effect of Needle Orientation and Closure Direction on Peritoneal Flap Reconstruction During TAPP Inguinal Hernia Repair”, sets out to test how needle orientation and closure direction influence peritoneal flap reconstruction. The trial is registered/planned at the Department of General Surgery, AIIMS Bibinagar; it is pre-recruitment and results are pending.

Approach

The trial is a prospective RCT with a planned sample of 80 patients undergoing laparoscopic TAPP inguinal-hernia repair, randomised across needle-orientation and closure-direction conditions, with a planned duration of approximately two years. The primary outcome is peritoneal closure time (minutes); secondary outcomes capture surgeon ease via the Subjective Mental Effort Questionnaire (SMEQ) and the Local Experienced Discomfort (LED) scale. Arun’s role is the planned data analysis and trial statistics in R.

Study design & outcomes

This section describes the planned, forward-looking design; as a pre-recruitment protocol, no findings are available yet.

• Primary outcome: peritoneal closure time (minutes).
• Secondary outcomes: surgeon ease measured by the Subjective Mental Effort Questionnaire (SMEQ) and the Local Experienced Discomfort (LED) scale.
• Comparison: needle orientation and closure direction during peritoneal flap reconstruction, in a randomised design with a planned n=80.

Outputs & impact

This collaborator-led trial protocol is registered/planned at AIIMS Bibinagar with recruitment yet to begin, so results are pending. Once conducted, the trial aims to provide controlled evidence on how needle orientation and closure direction affect peritoneal closure time and surgeon effort during TAPP repair, with planned data analysis led by Arun. Dissemination and the target journal are yet to be decided.