Laparoscopic totally extraperitoneal inguinal hernia repair versus open Lichtenstein hernioplasty: A randomized trial

Ibrahim, Ahmad Mohammed; Saad, Samy

doi:10.21608/asjs.2008.177018

Laparoscopic totally extraperitoneal inguinal hernia repair versus open Lichtenstein hernioplasty: A randomized trial

Document Type : Original Article

Authors

Department of General Surgery, Ain-Shams University, Cairo, Egypt

10.21608/asjs.2008.177018

Abstract

Surgical techniques of inguinal hernia repair have been evolving over the past decade. The present study was conducted to compare the outcomes of laparoscopic totally extraperitoneal inguinal hernia repair (TEP) and open Lichtenstein hernioplasty. A total of 72 patients with 80 inguinal hernias were recruited between April 2004 and February 2007, and were randomized to undergo either TEP or open Lichtenstein hernioplasty under general anesthesia. Group I consisted of 32 patients who underwent TEPs (bilateral repairs in 8 patients) while Group II comprised 40 patients who underwent unilateral open Lichtenstein hernioplasties. A prospective collection and analysis of data were performed. Only 2 patients in group 1 were converted to open surgery. The mean operation time for TEP (52 ± 17.2 min) was significantly shorter than for open Lichtenstein hernioplasty (64 ± 15.6 min) (p < 0.001). The pain score at rest was significantly lower in the TEP group than in the open group on postoperative days 0, 1, 4, 5, and 6. The mean length of hospital stay following laparoscopic and open repairs was 1.8 and
2.2 days respectively (P>0.05). On the average, the patients returned to work 8.2 days after TEP and 16.4 days after Lichtenstein hernioplasty (p < 0.05). Postoperative recovery and morbidity rates were otherwise comparable between the two groups. The incidence of chronic groin pain 1 year after TEP (9.4%) was significantly lower than after open surgery (22.6%) (p < /em>
< 0.05). None of the patients in either group showed recurrence at the last follow-up assessment.
In conclusion; postoperative recovery, morbidity rates and recurrence rates were comparable between the two groups. However TEP was superior to open Lichtenstein hernioplasty with regards to postoperative pain, time to return to work, and incidence of chronic groin pain.