Early Clinical Outcomes Following Laparoscopic Vs. Open Mesh Repair of Inguinal Hernia 85

Abstract

Background: As a part of modern surgical procedure, laparoscopic mesh repair of inguinal hernia should be safe, effective and have a short period of convalescence. Objective: This study was designed to compare the outcome following inguinal hernia repair, performed by laparoscopic technique and open mesh Lichtenstein (tension-free) repair. Materials and Methods: This prospective quasi experimental study was carried out in the department of surgery, Bangabandhu Sheikh Mujib Medical University, for a period of twelve (12) months. Total thirty six patients of inguinal hernia were included in this study. Result: Mean (±SD) age was 38.17 (±8.64) years. Mean (±SD) time for unilateral inguinal hernias were 55.30 (±11.01) minute in open mesh repair where as 76.07 (±13.71) minute in laparoscopically. For bilateral inguinal hernia, mean (±SD) time for open mesh repair was 92.4 (±10.26) minute and 81.2 (±10.44) minute in laparoscopically Seroma formation was in 4 patients of open mesh repair where as 5 patients of laparoscopic mesh repair. Sixteen patients of laparoscopic mesh repair needed more anaesthetic narcotics 16 patients of laparoscopic mesh repair had return to work within two weeks of surgery whereas only 10 (55.6%) patients of open mesh repair had return to work during same period of time. Pain at surgical site and discomfort was more in open mesh repair. Conclusion: Laparoscopic mesh repair is better than open mesh repair of inguinal hernia.

Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

“…20,22 The disadvantages of laparoscopic surgery include requirement of general anesthesia, longer operative time and learning curve and more expensive equipment. [22][23][24][25][26] The youngest patient in the present study was a 20 years old male and the oldest patient was 65 years old male with a mean of 52. 26 Also, the study of Singh et al, reported that mean age was 36.81 years and all patients were male.…”

“…[22][23][24][25][26] The youngest patient in the present study was a 20 years old male and the oldest patient was 65 years old male with a mean of 52. 26 Also, the study of Singh et al, reported that mean age was 36.81 years and all patients were male. 27 Whereas Koshariya et al reported that the youngest patient in his study was a 32-year-old male and oldest patient was 79-year-old male with a mean age 57.12 in laparoscopic hernia repair and 57.00 in open inguinal hernia repair and with a very high incidence of inguinal hernia in males (94%).…”

“…Faisal et al reported similar results that unilateral inguinal hernia was in 26 (72.2%) patients and bilateral inguinal hernia was in 10 (27.8%) patients 26. 20 (55.6%) patients were presented with indirect inguinal hernia and rest 16 (44.4%) patients had direct inguinal hernia.…”

“…34 Our results differ from those of Faisal et al who reported that seroma/hematoma formation was in 4 (22.2%) patients of open mesh repair whereas 5 (27.8%) patients of laparoscopic mesh repair. 26 Urinary retention was only in 3 (16.7%) patient of open mesh repair Testicular vessels were injured in six (16.7%) patients. There was no complication regarding injury to vas deferens, bowel injury or urinary bladder injury.…”

“…36 Faisal et al reported that 15 (83.3%) patients of laparoscopic mesh repair had two days or less hospital stay whereas 8 (44.4%) patients of open mesh repair had more than two days hospital stays and (66.7%) patients of laparoscopic mesh repair had return to work within 10 days whereas only 6 (33.3%) patients of open mesh repair returned to work within 10 days post-operatively. 26 16 (88.9%) patients of laparoscopic mesh repair had return to work within two weeks of surgery whereas only 10 (55.6%) patients of open mesh repair had return to work during same period of time. Helmy et al found that there was great difference between mean of time needed to regain activity between both groups, it was 26.3 in Group A (open) while in Group B (TAPP) was 5.73.…”