To compare the clinical efficacy, safety, and postoperative pain associated with laparoscopic transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair in adults with inguinal hernia, and to explore the potential mechanisms underlying differences in postoperative pain between the two procedures.

The clinical data of 180 adult patients with inguinal hernia treated at the Department of General Surgery, Anqing Municipal Hospital, between January 2022 and December 2024 were retrospectively analyzed. Patients were divided into a TAPP group and a TEP group according to the surgical procedure performed, with 90 patients in each group. Operative time, postoperative length of hospital stay, visual analog scale (VAS) pain scores at 24 hours after surgery, postoperative complications, and hernia recurrence rates during follow-up were compared between the two groups.

The operative time was significantly longer in the TAPP group than in the TEP group [(81.22±16.96) min vs. (62.33±14.72) min; t=7.84, P<0.001]. The VAS pain score at 24 hours postoperatively was significantly higher in the TAPP group than in the TEP group [(2.90±0.75) vs. (2.24±0.56); t=6.45, P<0.001]. No statistically significant differences were observed between the two groups in postoperative length of hospital stay, incidence of postoperative complications, or hernia recurrence rate during follow-up (all P>0.05).

TAPP and TEP repair have comparable overall clinical efficacy and safety in the treatment of adult inguinal hernia. Compared with TAPP, TEP is associated with a shorter operative time and less early postoperative pain. These differences may be related to peritoneal cavity entry, peritoneal incision and closure, and nerve irritation in the preperitoneal space.