A comparison of post operative pain and hospital stay between Lichtenstein's repair and Laparoscopic Transabdominal Preperitoneal (TAPP) repair of inguinal hernia: A randomized controlled trial.

Ishtiaq Ahmed

doi:10.12669/pjms.315.4811

Abstract

Objective:To compare the open Lichtenstein repair and laparoscopic mesh repair for direct inguinal hernias in terms of immediate post operative pain and length of hospital stay.Methods:This randomized control trial was conducted at Benazir Bhutto Hospital Rawalpindi from January 2009 to June 2010. All patients presenting in the surgical OPD with direct inguinal hernia, ASA I/II, were randomly divided in two equal groups. Group-I, patients underwent Lichtenstein’s repair and Group-II had hernioplasty by laparoscopic method (TAPP). Post operative pain intensity assessed by VAS and hospital stay measured in hours.Results:A total 60 patients of direct inguinal hernia were studied. The mean age was 61.48±7. The range of postoperative pain experienced was 5.55 as per VAS among all patients. In group-I (open hernioplasty) majority of patients (53.33%, n=16) experience severe type of pain where as in group-II, moderate severity of pain was reported by large number of patients (63.34%, n=19). The mean post operative pain intensity as per VAS was 6.23 in group-I and 4.43 in group-II patients. The mean length of hospital stay was slightly less (35.10 hrs) in group-I as compared to group-II (38.70 hrs).Conclusion:There is definitely less post operative pain after laparoscopic repair but hospital stay is same in both the procedures but laparoscopic procedure does increase the cost.

Highlights

History of hernia repair is very rich and since ancient times surgeons have tried to improve it bit by bit
Inclusion Criteria consist of male presenting to general-surgery clinic which are above thirty years of age with a diagnosis of direct inguinal hernia, Patients of ASA I & II category
A total of 60 patients having direct inguinal hernia admitted through the surgical OPD from January to December 2009

Summary

Introduction

History of hernia repair is very rich and since ancient times surgeons have tried to improve it bit by bit. It is a game of surgical anatomy, the one who understands the anatomy of Groin, can succeed in a way or the other to do a perfect repair. Post operative pain, prolonged hospital stay and recurrence are a common problem associated with hernia surgery. Failure rate of less than 1% is reported from centers specialized in hernia surgery in contrast to much higher recurrence form nonspecialized centers.[2]

Methods

Results

Conclusion