English

Abstract

INTRODUCTION: Inguinal hernias are treated by several surgical methods. Our main concern is to find a well-accepted method which is cost effective, with minimal complications, with small learning curve and can be attributed to the masses. OBJECTIVE: To compare the two tension- free methods of hernia repair: trans-abdominal pre-peritoneal laparoscopic mesh repair and the open Lichtenstein mesh technique in terms of operative time, length of hospital stay and chronic post-operative pain and cost effectiveness. MATERIALS AND METHODS: This study was conducted in Department of Surgery Rama Medical College Kanpur during March 2009 to Feb 2013 over a period of 4 years. A total of 264 male patients, aged between 16-60 years, were divided into two groups, A and B. Patients were subjected to Trans-abdominal Pre-Peritoneal (TAPP) laparoscopic and Lichtenstein repairs, respectively. The two groups were compared for operative time, length of hospital stay, chronic groin pain and cost of surgery. Percentages were calculated for categorical data while numerical data were represented as mean ± SD. Chi square test and t test were used to compare categorical and numerical variables, respectively. Probability ≤ 0.05 (P ≤ 0.05) was considered significant. RESULTS: At one month interval, in group A mild, moderate and severe pain was observed in 31 (26.5%), 12(9.09%) and 3 (2.3%) patients compared to 41 (31.6%), 35 (26.5%) and 12 (9.1%) patients, respectively, in group B. Mean operative duration was significantly longer in group A compared to group B (P < 0.001). Mean hospital stay was significantly longer in group B compared to group A (P < 0.001) and mean cost of the procedure was significantly high in group A as compared to group B (P<0.001). CONCLUSION: Trans-abdominal pre-peritoneal laparoscopic inguinal hernia repair is effective in decreasing the incidence of chronic groin pain and post- operative hospital stay in comparison with to tension free mesh hernioplasty. But due to long Surgical learning curve and high cost of surgery TAPP presently can't be attributed for mass scale surgery.