Extending indications of laparoscopic mesh repair of unilateral inguinal hernia in males, is it possible?

Abstract

Background Inguinal hernia repair is one of the most commonly performed operations in general surgery departments. Open Lichtenstein procedure is the gold standard in managing such cases. Mini-invasive approaches have gained popularity in the recent few decades by achieving better cosmetic results, shorter hospital stay, less postoperative pain, and earlier return to normal activities. Transabdominal preperitoneal (TAPP) mesh repair is one of the most accepted procedures among surgeons and patients. Aim To compare open Lichtenstein with TAPP mesh repair techniques in unilateral inguinal hernia in male patients regarding perioperative outcome and complications. Patients and methods This is a randomized comparative prospective study conducted from October 2016 to February 2017 on 71 cases presented with unilateral inguinal hernia and divided randomly into two groups: laparoscopic group (28 cases) and open group (43 cases). Both groups were studied and followed up for 1 year postoperatively, detecting intraoperative and early and late postoperative outcomes. Results The mean age was 36±15 years, and comorbidities were present in 32.4% of cases. Left, oblique, and funicular type were the most frequent cases. Operation time was 111±22 min in TAPP group and 75±16 min in open group. Occult hernia was detected in five (17.9%) cases, indirect hernia in three cases, and direct hernia in the other two cases of TAPP group. Intraoperative and postoperative complications were encountered in 10.7 and 28.6% of TAPP group, respectively, and in 9.4 and 20.9% of open group, respectively. Postoperative hospital stay was 2±1 day in both groups. Conclusion TAPP procedure can be performed safely in unilateral inguinal hernia in males with no serious complications. Moreover, it increases the ability to detect and repair the occult hernia in the same session. Longer operation time is the only drawback.