To investigate the clinical efficacy of transabdominal preperitoneal laparoscopic hernia repair (TAPP) versus totally extraperitoneal laparoscopic hernia repair (TEP) in elderly male patients with recurrent inguinal hernia, and their influences on respiratory function and testicular hemodynamic parameters.

A total of 104 elderly male patients with recurrent inguinal hernia admitted to the Second Hospital of Hebei Medical University from June 2021 to March 2024 were enrolled, and randomly divided into TAPP group and TEP group by the random number table method, with 52 cases in each group. The perioperative indicators, respiratory function indicators [airway pressure (Paw), end-tidal carbon dioxide partial pressure (P_ETCO₂)], trauma response indicators [tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6], testicular hemodynamic parameters [resistance index (RI), end-diastolic velocity (EDV), peak systolic velocity (PSV)], complication rates and postoperative recurrences of patients were compared between the two groups.

The operation duration and postoperative pain duration were shorter, and hospitalization costs were lower in the TEP group compared with the TAPP group, with statistically significant differences (all P<0.05). At 10 min and 30 min after pneumoperitoneum establishment, Paw and P_ETCO₂ values in the TEP group were significantly lower than those in the TAPP group (all P<0.001). Serum levels of TNF-α, IL-1β and IL-6 on postoperative day 1 and day 3 were markedly lower in the TEP group (all P<0.001). The TEP group had higher EDV and lower RI than the TAPP group (all P<0.001). No significant intergroup differences were found in the incidence of complications and 1year postoperative recurrence rate between the two groups (P>0.05).

TAPP and TEP are safe and effective treatment options for recurrent inguinal hernia in elderly males. However, TEP has a smaller impact on perioperative respiratory function, can alleviate pain and trauma stress, and reduces the economic burden on patients.