A comparative study between laparoscopic inguinal hernia repair and open inguinal hernia repair

Abstract

Background: Repair of inguinal hernia by the laparoscopic hernioplasty over open hernioplasty is preferable in terms of less postoperative pain and morbidity, wound complications, postoperative pain, early resumption of activity and work and better cosmetic results. Laparoscopic hernioplasty by totally extraperitoneal repair (TEP) technically eliminates the hazards of intra operational injuries. Methods: The study designed was an prospective, open labeled, randomized, comparative, two armed study during a period from December 2010–October 2012. After taking written consent from the patients were randomly allocated to two groups consisting 25 in each. Group OH were operated with open tension free Lichtenstein’s hernioplasty. Group TEP operated by laparoscopic totally extraperitoneal repair using mesh. Surgical variables and clinical outcomes were measured. Results: During the study no major life threatening complications were reported in either group only peritoneal breach was encountered intraoperatively in the TEP group and the difference found to be significant (p value = 0.000). Post operatively necessity of drain was seen in 9 patients out of 30 in TEP group. There were three (12%) cases of immediate mesh displacement in TEP group but none in the OH group. It was observed that the mean time taken to complete a laparoscopic hernia repair was significantly higher (p value = 0.000) in TEP compared to open procedure. The postoperative pain score and need of analgesics, presence of surgical site infections were more in OH group compared to TEP group. The time taken for resumption of daily activities and work was earlier in patients treated with TEP compared to open surgery (p <0.005) and good significant cosmetic results was also observed with the same group only (p <0.00). Conclusions: Laparoscopic hernia repair is safe and provide less postoperative morbidity in experienced hands compared to open hernia repair.