Publication:

Early and late outcomes of trans-abdominal pre-peritoneal and Lichtenstein repair for inguinal hernia, a comparative study

Background Surgical repair of inguinal hernia remains a common operation in general surgery. No consensus has been achieved on the best surgical technique of inguinal herniorrhaphy. Open repair has lower recurrence and complication rates. Laparoscopic approach has less postoperative pain, reduced recovery time, earlier return to activity and fewer wound complications but expose the patient to potential complications, mainly possibility of visceral injury. The aim was to compare early and late outcomes after TAPP and lichtenstein repair.

Methods Three hundreds patients with inguinal hernia were enrolled in this study, divided into two equal groups:  Group I managed by trans-abdominal pre-peritoneal laparoscopic repair (TAPP) and Group II managed by open lichtenstein repair (LR).

Results The operative time was significantly lower in TAPP than LR (50±18.98 min and 75±24.54 min respectively). TAPP has a significant advantage to diagnose and repair contra-lateral inguinal hernia (11.5%) and to repair concomitant umbilical hernia (7.3%). No significant difference between both groups regarding intra-operative visceral injury, ileus, hospital stay or wound complications. TAPP significantly decreased post-operative pain and groin hypothesia, shorten the duration needed to return to activities (7±3 days and 16±5 days respectively). There was no significant difference between both groups regarding the recurrence (4.2% and 2% respectively).

Conclusions TAPP technique is an excellent approach for treatment of inguinal hernia in comparison to LR either unilateral or bilateral, primary or recurrent inguinal hernia with low morbidity and recurrence comparable to that of LR with advantages of less post-operative pain and early return to activities.