Transabdominal Pre-peritoneal Mesh Repair versus Lichtenstein’s Hernioplasty

Abstract

Background: In the era of minimal invasive surgery, hernia repair has seen a paradigm shift from open to laparoscopic technique. However, superiority of laparoscopic repair over open repair is still controversial. Available literatures have shown laparoscopic technique to be better in term of post-operative pain and early return to work.Methods: In this prospective study, a total of 102 patients aged 21-78 years with inguinal hernia were recruited and enrolled into two comparative groups, namely Lichtenstein’s and Transabdominal pre-peritoneal, and each group containing 51 participants. Hospital ethical committee approval and written informed consent from patients was obtained. Primarily, the duration of operation, post-operative pain and complication, and quality of life after surgery was compared between the two different approaches of hernia repair.Results: The study results demonstrated a statistically significant superiority of trans abdominal pre-peritoneal repair over Lichtenstein’s hernioplasty in terms of post operative pain (2.00±0.63 vs 3.90±0.74 VAS score, P value<0.001), hospital stay (2.33±0.62 vs 2.96±0.20 days, P value <0.001) and quality of life with early return to normal work (13.39±0.60 vs 17.88±0.86 days, P value <0.001); whereas a prolonged operative time was seen in transabdominal pre-peritoneal repair (96.08±27.08 vs 42.55±5.95 mins, P value <0.001). Conclusions: This study has shown that transabdominal pre-peritoneal repair is better than Lichtenstein’s in respect to post-operative pain, quality of life and post-operative complication. However, it has prolonged operative duration than conventional method.

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

“…31 While Koju et al reported a significant difference in pain score with low pain score in TAPP group was seen to be (2.00±0.63 versus 3.90±0.73, p<0.001). 33 Also Garg et al reported that at 0, 12, 24 and 72 hours postoperatively, LH patients described significantly less pain than the open group (p<0.05). 32 Although the visual analogue scale (VAS) pain scores of the LH group were also lower than the OH group on postoperative day 14, these differences were not statistically significant.…”

“…Also Our results differ from those of Koju et al who reported that there were two wound infections and one seroma formation in conventional group whereas in TAPP group there were three recurrence (one after 3 months, one after 2 weeks and one after one year of surgery) and one conversion due to adhesion. 33 . Whereas Shah et al found in his study, that the mean period of hospitalization was slightly higher 3.5 days in case of laparoscopic hernia repair with 3.23 days in cases of hernioplasty but not statistically significant.…”

“…31 Koju et al found that the average hospital stay in TAPP and Lichtenstein's group was 2.33±0.62 and 2.96±0.20; p<0.001, respectively also, there was early return to normal work in TAPP group than in Lichtenstein's group (13.39±0.60 versus 17.88±0.87 days, p<0.001). 33…”

“…While Garg et al, reported that in laparoscopic group unilateral hernia was 68.6% and in 31.4% it was bilateral while in open hernioplasty group 80% of patients had unilateral hernias and 20% had bilateral hernias also he reported that in laparoscopic group 71.4% of patients had direct hernias and 28.6% of patients had indirect hernias, while in Lichtenstein group 57.1% of his patients had direct hernia and 42.9% had indirect hernia 32. Koju et al in his study, reported that in 1.96% of his cases hernia was bilateral and in 98.04% it was unilateral in open hernioplasty group and in TAPP group 13.73% of the cases had bilateral hernia and 86.27% of them had unilateral hernias, of these patients, 19.6% direct and 80.4% indirect hernias in open group while in TAPP group 21.57% direct and 78.43% indirect 33. In the present study mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes.…”

Method of the postsurgical seroma prevention in patients with direct groin hernia during transabdominal preperitoneal repair

“…Основные преимущества лапароскопического доступа -это ранняя реабилитация, гладкое течение раннего послеоперационного периода, возможность выполнения одновременной двусторонней пластики, в том числе при бессимптомной грыже [1,3].…”