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Introduction Inguinal hernia is a common surgical problem throughout the world. Currently, the management options available are open mesh hernioplasty and laparoscopic mesh repair. Laparoscopic mesh repair can be performed by either transabdominal preperitoneal (TAPP) repair or totally extraperitoneal (TEP) repair. Many studies comparing the two procedures have been unable to establish the superiority of one procedure over the other and have yielded conflicting results. Thus, we performed this study to compare TAPP and TEP. Aim The aim of this study is to compare the clinical outcomes and safety of laparoscopic TEP and laparoscopic TAPP for inguinal hernia repair. Materials and methods Patients were randomly divided into two groups on the basis of surgical procedures. The first group of patients underwent laparoscopic TAPP mesh repair, and the second group of patients underwent laparoscopic TEP mesh repair. Their intraoperative and postoperative findings were noted. Patients were followed up at regular intervals for up to six months. Results The mean age and mean weight distribution between the two groups were not significant. The duration of surgery needed (in minutes) for TAPP was found to be significantly less compared to TEP. In the TEP group, conversion to open occurred for three subjects (6.7%) while there was no conversion in the TAPP group. Postoperative pain at 24 hrs was found to be higher in TAPP subjects compared to that in TEP subjects, but the difference was statistically insignificant. Tolerance to a liquid diet started few hours after surgery was found to be the same in both groups. Association of the duration of hospital stays with the type of surgery was not significant. Six subjects (13.2%) showed hematoma in the TEP group while five subjects (11%) in the TAPP group showed hematoma after one week of surgery. Eight subjects (17.6%) showed seroma in the TEP group while three subjects (15.4%) in the TAPP group showed seroma after one week of surgery. Two subjects (4.4%) showed superficial wound infection in both the TEP group and TAPP group after one week of surgery. Four subjects each (8.9%) showed scrotal edema in the TEP group as well as the TAPP group after one week of surgery. No subject showed port site hernia without closure of the sheath at one-week, one-month, and six-month follow-up visits. Two subjects (4.4%) each showed groin pain in the TEP group as well as the TAPP group after one week of surgery. There were no instances of bowel obstruction or mesh infection. Conclusion TEP is a more skill-demanding procedure as compared to TAPP and thus takes more time to perform. However, it is superior on account of not breaching the peritoneum. TAPP is favorable for larger hernias. The choice of procedure should be individualized according to the patient's characteristics and surgeon's preference.
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Statement of problem Dental restorations are subjected to tensile stresses from oblique or transverse loading of their complex geometric forms, making tensile strength a fundamental mechanical property. Since composite core build-up materials are brittle, the integrity of the post and core depends on their tensile strength and resistance to fracture when utilized with various prefabricated post systems. Therefore, it is essential to determine the tensile strength of the prefabricated metallic and nonmetallic posts used to reinforce the composite resin core. Purpose This study compared the diametral tensile strength (DTS) of three prefabricated post systems with composite core build-up material. Material and methodology Ten composite resin cores from four different groups were formed. The control group was the composite resin core without a post (group 1). Group 2 was composed of composites with metal posts, group 3 was composed of composites with glass fiber posts, and group 4 was composed of composites with carbon fiber posts. All the samples were kept in a humid place for seven days to mimic the conditions in the mouth. DTS was determined by recording the tensile force required to fracture the core material by performing a diametral compression test for tension after a week. The observations were analyzed using a one-way analysis of variance (ANOVA), followed by a post-hoc test. Results The tensile strength of the resin core material was decreased by 28.1%, 20.8%, and 10.4% by using posts made of stainless steel, carbon fiber, and glass fiber, respectively. Among the three post systems, stainless steel had the lowest mean DTS values, while glass fiber had the highest mean DTS values. Conclusion Composite core glass fiber post systems showed higher tensile strength than other post systems.
