To compare the effect of carbon dioxide (CO₂) pneumoperitoneum on electrocardiogram (ECG) during laparoscopic transabdominal preperitoneal hernia repair (TAPP) and totally extraperitoneal hernia repair (TEP).

Clinical data of 120 patients with primary inguinal hernia in Beijing Chaoyanghospitalbetween June to November 2019 were collected. All patients were randomly divided into the TAPP group and the TEP group. By comparing the electrocardiogram situation of patients before and after operation and intraoperative hemodynamic changes, the influence of pneumoperitoneum on electrocardiogram of the two surgical methods was analyzed.

The operation time of patients in TEP group was (41.32±8.09) minutes, shorter than that in TAPP group [(45.2±12.33) minutes], and the difference was significant (P<0.05).There was no statistically significant difference between the two groups in terms of anesthesia duration [(58.4±12.11) minutes vs (59.27±8.69) minutes, P>0.05]. Acute pain occurred in 2 cases (3.33%) in TAPP group, and 4 cases (6.67%) in TEP group, without statistical significance (P>0.05). There were no intraoperative complications in both groups, such as severe bleeding, vas deferens injury, spermatic vessels injury, andintestinal or bladder injury. There were no perioperative complications in both groups, such as urinary retention, delirium and venous thrombosis.In terms of the abnormalities in electrocardiogram, postoperative heart rate (HR) and postoperative mean arterial pressure (MAP), the differences between the two groups were significant (P<0.05). There were no significant differences in preoperative HR and preoperative MAP between the two groups (P>0.05).

Compared with TAPP, TEP surgery has a disadvantage in terms of intraoperative ECG influence. TEP surgery may cause more abnormal changes in ECG, which requires closely monitoring.