Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials

Abstract

Endoscopic repairs do have advantages interms of local complications and pain-associated parameters. For more detailed evaluation further well-structured trials with improved standardization of hernia type, operative technique, and surgeons' experience are necessary.

Comparison of Lichtenstein and Laparoscopic Transabdominal Preperitoneal Repair of Recurrent Inguinal Hernias

“…Our study has shown that operation time is shorter in the Lichtenstein group (59.6 6 9.9 minutes) than in the TAPP group (64.4 6 8.4 minutes), although because of the small sample size, this trend did not reach a statistical significance (P 5 0.068). Our data are similar to the data from several other investigations, 15,19,25 although Eklund et al 16 found no difference in the operation time between the laparoscopic and Lichtenstein methods.…”

“…The same advantages of the laparoscopic method in comparison with the Lichtenstein approach are documented also by other authors. [14][15][16]19,25 There were no differences found in the total number of early complications between the open and laparoscopic methods (33.3% versus 14.3% for TAPP and Lichtenstein, respectively; P 5 0.19). Authors of some previous studies have shown that laparoscopic methods are characterized by fewer postoperative complications than Lichtenstein operations.…”

“…16,25 Based on their investigations, Neumayer et al 14 came to the opposite conclusion-that open surgical interventions have fewer postoperative complications than laparascopy. Schmedt et al 15 conducted a meta-analysis in which they showed that wound infection and hematoma are less frequent in cases of endoscopic surgery, whereas seroma is less frequent in cases of the Lichtenstein method. Our data on the structure of the postoperative complications show that frequencies of wound complications (infection, hematoma, seroma) are almost equal in both groups.…”

“…By this factor our investigation corresponds to the data by Eklund et al, 16 although it should be mentioned that larger studies have shown that laparoscopic methods are characterized by fewer chronic pain episodes than instances of Lichtenstein approach. 15,19 Taking into the consideration the characteristics of the recurrent inguinal hernia, it is important to emphasize that the correction of this disorder should be done by an experienced hernia surgeon who will take into consideration the specific features of each individual patient and who will make a decision regarding which type of surgical intervention should be chosen in each specific case according to the patient's characteristics (age, comorbidities, and other risk factors, especially those related to anesthesia, physical activity, etc). [6][7][8]11,17 It is apparent that in all cases of hernioplasty, meshes must be used.…”

“…6,8,9 Although it is still disputable which approach, open or endoscopic, is more preferable, both methods have positive and negative characteristics. [10][11][12][13][14][15][16][17][18][19][20] The aim of our prospective randomized trial was the comparison of the results of two methods of treatment of recurrent inguinal hernia: tension-free repair by the Lichtenstein technique, and one of the two most widely used laparoscopic methodstransabdominal preperitoneal (TAPP) repair.…”