Comparative Study Of Laparoscopic Transabdominal Preperitoneal Versus Lichtenstein Tension Free Repair For Inguinal Hernia

Abstract

Background and Objectives “A comparative study of laparoscopic transabdominal preperitoneal versus Lichtenstein tension free repair for inguinal hernia”, is a prospective study of 60 cases of inguinal hernias which were treated by either open inguinal hernia mesh repair (Lichtenstein) or laparoscopic inguinal hernia repair (TAPP). The study was conducted with an objective to compare the effectiveness of these procedures and complications, if any. Methods 60 cases of inguinal hernia admitted and operated in B.L.D.E.U.’s Shri B M Patil Medical College, Hospital and Research Centre, Vijaypur were selected alternatively. All patients with uncomplicated direct and indirect hernias treated by open Lichtenstein tension free inguinal mesh repair or laparoscopic transabdominal preperitoneal (TAPP) inguinal mesh repair approach were included. After preoperative preparation they were alternatively chosen for either open or laparoscopic repair. The age/ sex incidence, mode of presentation, precipitating factors, surgical treatment and postoperative complications were all evaluated and compared with standard published literature. Results In the post-operative period pain was more in open Lichtenstein group compared to TAPP. Post- operative complications were more in open Lichtenstein group, hematoma at the operated site was found in 1 case and seroma developed in 3 patients in cases of hernioplasty. One patient developed chronic inguinal pain in X Lichtenstein group. The mean duration of hospitalization after surgery was 5.5 days in hernioplasty group whereas 2.2 days in the laparoscopic (TAPP) group. The duration for surgery was significantly longer in the laparoscopic group with mean operating time of 98.7 minutes. Return to work is significantly early in case of laparoscopic (TAPP) group. Conclusion In this study incidence of hernia is more in farmers. Duration of surgery is significantly high in case of laparoscopy (TAPP) due to learning curve of the procedure. Post operatively pain was significantly less in laparoscopic (TAPP) repair. Postoperative complication and chronic inguinal pain was less in TAPP group. Duration of hospital stay after surgery was significantly less in laparoscopic (TAPP) cases. Return to work was very early in case of TAPP. With limited follow up, it can be concluded that laparoscopic (TAPP) repair is better compared to Lichtenstein repair, except in case of duration of surgery in TAPP due to long learning curve.