Outcome of inguinal hernia repair total extraperitoneal laparoscopic hernia repair versus open tension free repair (Lichtenstein technique).

BACKGROUND: Result and efficacy of laparoscopic hernioplasty has been controversial. Many techniques have been performed and evaluated. Totally extraperitoneal laparoscopic hernia repair (TEP) technique has been used for laparoscopic hernioplasty in this center. Complications, benefit and efficacy in terms of recurrence were studied and compared with open tension free repair (Lichtenstein).

METHOD: Fifty-five patients with 4 recurrent, 16 bilateral and 35 unilateral groin hernia underwent laparoscopic hernioplasty by the TEP technique. The other twenty-four patients with I recurrent 2 bilateral and 21 unilateral groin hernia underwent Lichtenstein hernioplasty (OH). Operative time, complications, hospital stay and recurrence after 1 year follow-up were recorded.

RESULT: Mean operative time was 67.85 +/-21.66 and 55.85 +/- 10.60 minutes. Mean difference was 12.00, 95 per cent CI (1.83, 22.16) p-value 0.02 (TEP and OH). Mean hospital stay was 2.71 +/- 1.29 and 2.38 +/- 0.58 days. Mean difference was 0.33, 95 per cent CI (-0.26, 0.93) p-value 0.27 (TEP and OH) complication rate 12.7 per cent and 12.5 per cent p-value 0.64 (TEP and OH). Most complications were minor such as seroma, hematoma, neuralgia, one case of pubic osteitis needed to remove staples and some parts of the mesh. There was one conversion to open repair due to large sac and large bowel adherence. There was one recurrence after one year follow-up in the laparoscopic group, no major morbidity or mortality in this study.

CONCLUSION: This study demonstrated that complications of the TEP technique were minimal and it was safe to perform. Although the operative time was longer and there was one recurrence in the TEP group, that might be because of the early learning period for a new surgical procedure