***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The open tension-free mesh-plug hernia technique , transabdominal preperitoneal ( TAPP ) technique , and totally extraperitoneal ( TEP ) laparoscopic technique all are common surgical procedures for primary unilateral inguinal hernia repair . However , the choice of the right surgical procedure still is controversial in China . This study aim ed to compare open tension-free hernioplasty with two laparoscopic hernia repairs . Methods In this study , 164 male patients with primary unilateral inguinal hernia were r and omized to undergo an open operation with mesh-plug and patch , TAPP , or TEP . Results Completion of the study required 3 years , from February 2006 to February 2009 . Of the 164 patients , 62 underwent open repair , 50 had TAPP , and 52 had TEP . The patients then were followed up for 15.6 ± 8.5 months . The average operating time for the open repair group was significantly shorter than for the other two groups ( p < 0.001 ) . The cost for the open repair group also was significantly less than for the other two groups ( p < 0.001 ) . By contrast , the pain scores in the open mesh group were significantly higher than in the other two groups ( p < 0.001 ) . The hospital stay and the recovery time both were significantly longer in open repair group than in the other two groups ( p < 0.001 ) . No major complications or recurrence was found in any of the groups . Conclusions The findings show that open tension-free mesh-plug hernia repair , TAPP , and TEP  are safe and effective for patients with primary unilateral inguinal hernia . Both TAPP and TEP are superior to open repair in terms of less postoperative pain and faster recovery time . The authors therefore recommend laparoscopic repair techniques as the preferable choice of surgical procedure . However , they think open repair will remain a practical solution in China because of its lower cost , short learning period , and need for no special equipment Background Data are insufficient to compare transabdominal preperitoneal repair ( TAPP ) and total extraperitoneal ( TEP ) techniques of  laparoscopic inguinal hernia repair .  There is very scant data comparing the two techniques in terms of long-term outcomes , which include chronic groin pain , quality of life , and time to return to normal activity . This prospect i ve , r and omized , controlled trial compared TEP versus TAPP techniques of laparoscopic inguinal hernia repair in terms of these long-term outcomes . Methods This study was conducted from May 1 , 2007 to March 30 , 2012 . Patients with uncomplicated groin hernia were r and omized to transabdominal preperitoneal ( TAPP ) or totally extraperitoneal ( TEP ) techniques .  A total of 160 patients were r and omized to group I ( TEP ) and 154 patients to group II ( TAPP ) .  Pain was assessed with Visual Analogue Scale ( VAS ) preoperatively and postoperatively at 24 h , 1 week , 6 weeks , 3 , 6 , and 12 months , and yearly thereafter . Quality of life was assessed with Short Form–36 version 2 ( SF 36v2 ) preoperatively and postoperatively at 3 months follow-up . Results Demographic , clinical profiles , intraoperative , and early postoperative parameters were well matched . There was significantly higher acute pain following TAPP repair ; however , the chronic groin pain was comparable in both TEP and TAPP . Preoperative pain and immediate postoperative pain had significant correlation with chronic groin pain . Significant improvement from preoperative to postoperative quality of life was seen in both TEP and TAPP repairs , but there was no difference between TEP and TAPP in postoperative period . Time to return to normal activity also was similar between the two groups . Conclusions The TEP and TAPP techniques of laparoscopic repair of inguinal hernia have comparable long-term outcomes in terms of incidence of chronic groin pain , quality of life , and resumption of normal activities . Chronic groin pain had a significant correlation with preoperative pain and early postoperative pain . However , TAPP was associated with significantly higher incidence of early postoperative pain , longer operative time , and cord edema , whereas TEP was associated with a significant higher incidence of seroma formation . The cost was comparable between the two AIM To compare four approaches in primary repair of inguinal hernia as regards operative and postoperative outcome . METHODS One hundred consecutive patients with primary inguinal hernia Nyhus I-III were r and omized into four groups . Group I had open pro-peritoneal repair , group II had Lichtenstein tension-free mesh repair , group III had Transabdominal pro-peritoneal ( TAPP ) repair while group IV had laparoscopic totally extraperitoneal ( TEP ) hernia repair . RESULTS Operative time ranged from 10.71 to 120.61 min . Laparoscopic operations were significantly longer than open operations ( 54.5 + 13.2 , 34.21 + 23.5 versus 96.12 + 22.5 , 77.4 + 43.21 ; t=3.891 , p<0.001 ) . Open pro-peritoneal approach had significantly longer operative time compared to Lichtenstein approach ( 54.5 + 13.2 versus 34.21 + 23.5 ) . Postoperative pain was significantly higher in patients who had open repairs ( 7.067 + 1.831 , 6.5 + 3.5 versus 5.8 + 1.568 , 4.8 + 2.33 ; t=3.424 , p=0.002 ) . There was one case of conversion in each of the two laparoscopic groups . Laparoscopic operations were associated with significantly faster return to normal domestic activities and to work . CONCLUSION Laparoscopic hernia repair offers less postoperative pain and faster recovery on the expense of longer operative time . TEP and TAPP laparoscopic techniques gave similar results Background There is very scant literature on the impact of inguinal hernia mesh repair on testicular functions and sexual functions following open and laparoscopic repair . The present r and omized study compares TAPP and TEP repairs in terms of testicular functions , sexual functions , quality of life and chronic groin pain . Methods This study was conducted from April 2012 to October 2014 . A total of 160 patients with uncomplicated groin hernia were r and omized  to either trans-abdominal pre-peritoneal ( TAPP ) repair or totally extra-peritoneal ( TEP ) repair .  Testicular functions were assessed by measuring testicular volume , testicular hormone levels preoperatively and at 3 months postoperatively . Sexual functions were assessed using BMSFI , and quality of life was assessed using WHO-QOL BREF scale preoperatively and at 3 and 6 months postoperatively . Chronic groin pain was evaluated using the VAS scale at 3 months , 6 months and at 1 year . Results The median duration of follow-up was 13 months ( range 6–18 months ) . The mean preoperative pain scores ( p value 0.35 ) as well as the chronic groin pain were similar between TEP and TAPP repairs at 3 months ( p value 0.06 ) and 6 months ( p value 0.86 ) . The testicular resistive index and testicular volume did not show any significant change at follow-up of 3 months ( p value 0.9 ) in the study population . No significant difference was observed in testicular resistive index and testicular volume when comparing TEP and TAPP groups at at follow-up of 3 months ( p value > 0.05 ) . There was a statistically significant improvement in the sexual drive score , erectile function and overall satisfaction over the follow-up period following laparoscopic inguinal hernia repair . However , sexual function improvement was similar in patients undergoing both TEP and TAPP repairs . All the domains of quality of life in the study population showed a significant improvement at a follow-up of 3 and 6 months . Subgroup analysis of all the domains of quality of life in both TAPP and TEP groups showed a similar increment as in the study population ( p value < 0.001 ) ; however , the mean scores of all the domains were comparable between the two subgroups ( p value > 0.05 ) , preoperatively and 3 and 6 months follow-up . Conclusions Laparoscopic groin hernia repair improves the testicular functions , sexual functions and quality of life , but TEP and TAPP repairs are comparable in terms of these long-term outcomes Background The current prospect i ve r and omized controlled clinical study aim ed to assess the short- and long-term results of recurrent inguinal hernia repair , and to compare the results for transabdominal preperitoneal ( TAPP ) and totally extraperitoneal ( TEP ) procedures with those for open tension-free repair . Methods For this study , 82 patients were r and omly assigned to undergo TAPP ( group A , n = 24 ) , TEP ( group B , n = 26 ) , or open Lichtenstein hernioplasty ( group C , n = 32 ) . All the patients with recurrent inguinal hernias had undergone previous repair using conventional open procedures . Physical examination showed  Nyhus type II hernia in the vast majority of the patients ( 59 % ) . High-risk patients ( American Society of Anesthesiology [ ASA ] III or IV ) ; coagulation disorders ; previous abdominal or pelvic surgery ; and irreducible , congenital , and massive scrotal or sliding hernias were excluded from the study . Results There was a statistically significant difference ( p = 0.001 ) in operating time favoring the open procedure . The intensity of postoperative pain was greater in the open hernia repair group 24 h , 48 h , and 7 days after surgery ( p = 0.001 ) , with a greater consumption of pain medication among these patients ( p < 0.004 ) . The median time until return to work was 14 days for group A , 13 days for Group g , and 20 days for group C. The comparison was in favor of laparoscopically treated patients . Nine recurrences ( 4 in the laparoscopic groups and 5 in the open group ) were documented within 3 years of follow-up evaluation . Conclusion Laparoscopic inguinal hernia repair ( TAPP or TEP ) is the method of choice for dealing with recurrent inguinal hernia Background The aim of this prospect i ve r and omized multicenter trial was to evaluate the recurrence rates and complications of  open versus laparoscopic repairs  of inguinal hernias . Methods Patients with primary unilateral inguinal hernias were r and omized to Shouldice repair , Bassini operation , tension-free hernioplasty ( Lichtenstein repair ) , laparoscopic transabdominal extraperitoneal hernioplasty ( TEP ) , or laparoscopic transabdominal preperitoneal hernioplasty ( TAPP ) .  The primary outcome parameter was the rate of recurrence at 3 years . The secondary outcome was the rate of intraoperative , perioperative , and long-term complications . Follow-up comprised of clinical examination after 1 , 2 , and 3 years . Results Three hundred and sixty-five patients were r and omly assigned to one of the five procedures . The intention-to-treat analysis showed that the cumulative 3-year recurrence rate was 3.4 % in the Bassini group , 4.7 % in the Shouldice group , 0 % in the Lichtenstein group , 4.7 % in the TAPP group , and 5.9 % in the TEP group ( p = 0.48 ) . Comparing open ( Bassini , Shouldice , Lichtenstein ) versus laparoscopic ( TAPP , TEP ) techniques ( p = 0.29 ) and comparing the use of mesh prostheses ( Lichtenstein , TAPP , TEP ) versus suturing techniques ( Bassini , Shouldice ) ( p = 0.74 ) showed no significance in the rate of recurrence . The rates of intraoperative ( p = 0.15 ) , perioperative ( p = 0.09 ) , and long-term complications ( p = 0.13 ) were without significance between the five groups . Comparing mesh techniques ( Lichtenstein , TAPP , TEP ) versus suturing techniques ( Bassini , Shouldice ) showed no significance in the rate of complications . The per- protocol analysis for the comparison of mesh ( Lichtenstein , TAPP , TEP ) versus suturing ( Bassini , Shouldice ) techniques revealed that recurrences ( p = 0.74 ) , intraoperative ( p = 0.64 ) , perioperative ( p = 0.27 ) , and long-term complications ( p = 0.91 ) were evenly distributed . Conclusions In this multicenter study , no significant difference in the recurrence rate and complications between laparoscopic and open methods of hernia repair was revealed OBJECTIVE To compare the effects of laparoscopic inguinal hernia repair ( LIHR ) and Lichtenstein tension-free inguinal hernia repair and to explore the safety and feasibility of LIHR as well as the advantages and disadvantages of these procedures . SUBJECTS AND METHODS In total , 252 patients with inguinal hernia were equally r and omized into the  transabdominal preperitoneal ( TAPP ) repair , totally extraperitoneal ( TEP ) repair , and Lichtenstein tension-free hernia repair groups  ( n=84 each ) . Operating time , postoperative pain scores , postoperative scrotal seroma , postoperative local esthesiodermia , postoperative chronic pains , postoperative long-term hernia relapse , and costs of hospitalization were compared among the three groups . RESULTS All laparoscopic operations were performed smoothly without intraoperative conversion to open surgery . The LIHR groups showed significantly better effects on postoperative p 
    Output:
    
Conclusions TEP and TAPP have their own advantages .
TEP repair reduces short-term postoperative pain more effectively than TAPP repair and results in shorter hospital stay of primary cases .
In contrast , TAPP repair is correlated with shorter surgery duration .