Publication:

Comparison of laparoscopic totally extraperitoneal mesh hernioplasty with Lichtenstein tension free mesh hernioplasty

Background The purpose of the study was to observe the differences between the two methods of inguinal hernia repair in terms of operative time, postoperative pain, need for analgesia, hospital stay and postoperative complications.

Methods This prospective study conducted in the department of Surgery, IGMC Shimla, included 40 patients of inguinal hernia who were randomized to TEP and Lichtenstein tension free mesh hernioplasty groups randomly. After thorough clinical examination, whereas all patients with unilateral incomplete inguinal hernia fit for laparoscopic surgery were included in the present study, those with bilateral inguinal hernia, unwilling for laparoscopic surgery or who had complicated and recurrent inguinal hernia, poor cardiopulmonary reserve or were immunocompromised were excluded from the study.

Results Laparoscopic TEP is significantly lengthier procedure than open Lichtenstein repair especially in the learning phase as the mean operative time of TEP repair was 75.6 minutes and that of open Lichtenstein repair was 54 minutes. Not only postoperative pain recorded by using VAS was significantly less in the in the first 4 postoperative hours there was significantly less consumption of post-operative analgesic in TEP as compared to Lichtenstein group. No major complications in either group but only minor complications were observed in TEP group.

Conclusions TEP can be recommended to those desiring better cosmetic results and early return to work as TEP was found to be associated with less pain in the first 4 hours after surgery.