655 Is It Time to Change Practice in Patients with Unilateral Inguinal Hernia – a Comparative Study of Laparoscopic vs Open Hernia Repair in LMIC Country

Abstract

Abstract Aim Our aim was to assess if a return to regular activity is improved in patients undergoing one-sided inguinal hernia repair. This is critical in LMIC countries where finances are constrained, and the cost of laparoscopic repair is significantly higher than the open technique. Method The study was conducted at Aga Khan University Hospital, Pakistan. Patients between ages 16 to 65 planned for unilateral inguinal hernia repair were selected using non-probability consecutive sampling. Patients were selected from 1st May 2016 till 30th April 2017 and were divided into two groups. Group A included patients having laparoscopic TAP repair while Group B consisted of Liechtenstein hernia repair. All patients were followed at 1 week for resumption of regular activities, at 1 and 3 years for recurrence, the study was concluded on 30th April 2020. Results A total of 60 patients were enrolled in this study. Group A and B each had included 30 patients. The mean duration of return to work in group A was 5.33 ± 4.46 days and for group B it was 6.83 ± 4.58 days. There was 1 recurrence seen at 3 years in Group A. Conclusions Hernia recurrence is not different from the technique of repair at 1-year follow-up. Laparoscopic repair although is associated with little early return to work when compared with open technique but this difference was not statistically significant in our study. The decision of the type of repair should be balanced between surgeon expertise and patient's wishes.