Prospective Randomized Study Comparing Laparoscopic and Open Tension-free Inguinal Hernia Repair with Shouldice’s Operation

Zieren, Jürgen; Zieren, H. U.; Jacobi, C. A.; Wenger, F. A.; Müller, Jochen

doi:10.1016/s0002-9610(98)00004-x

Cited by 115 publications

(74 citation statements)

References 3 publications

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“…Thirty-three randomized controlled trials with a total of 5,053 random patients were used for the evaluation [11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45]. Due to the separate publication of partial aspects [40, 45]and late results [11, 12, 14, 18], a total of 36 publications was analyzed.…”

Section: Resultsmentioning

confidence: 99%

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Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Schmedt¹,

Leibl²,

Bittner³

2002

Dig Surg

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Aims: This article provides an overview of randomized studies which compare endoscopic hernia repair techniques (TAPP/TEP) with the Shouldice and Lichtenstein repair. Methods: Systematic analysis of 33 published studies which meet the criteria of a randomized controlled trial with a high evidence level. Results: The majority of the studies document statistically significant advantages of the endoscopic repair techniques in relation to wound pain (15/22), need for analgesics (16/21), return-to-work time (16/22) and physical activity (18/25), although only one study showed significant advantages of the Lichtenstein method. Six of 28 studies showed a lower morbidity in comparison to open approaches, although 22 of 28 studies documented no significant difference. The first long-term studies with follow-up periods between 5 and 6 years also show advantages of the endoscopic techniques. Conclusion: Even with cautious interpretation of the data, it is clear that endoscopic techniques are more comfortable for patients and that morbidity is no higher than for open procedures. Due to the short follow-up periods final evaluation regarding long-term complications and recurrence is not yet possible.

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Section: Resultsmentioning

confidence: 99%

“…Four studies were published as abstracts only [16, 29, 35, 42]. Three studies [21, 23, 24]included 2 control groups thus presenting 3 study arms.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Schmedt¹,

Leibl²,

Bittner³

2002

Dig Surg

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“…However, recent studies have reported that strangulation is no longer a contraindication for tension-free mesh repair (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Wound Infection-recurrencementioning

confidence: 99%

Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

et al. 2016

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“…9 Initially, TAPP was used and TAPP related some complications were reported previously. 10,11,12 The complications noted earlier were minimised and both TAPP and TEP yielded equally better results. But TEP is preferred more than TAPP method presently.…”

Section: Resultsmentioning

confidence: 94%

A Comparative Study of Laparoscopic Tep and Open Lichtenstein’s Tension-Free Hernia Repair: A Single Surgical Unit Experience

Galeti¹,

Gundluru²,

Sowdagar³

2016

jemds

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BACKGROUNDThis is a prospective study involving 50 cases of unilateral inguinal hernia, 25 of whom underwent open Lichtenstein's repair and the remaining, Laparoscopic Total Extraperitoneal (TEP) Repair. The study deals with a comparison of the effectiveness of these two types of repair. MATERIALS AND METHODS50 patients of unilateral inguinal hernia admitted in PES Medical College, Kuppam, Andhra Pradesh, India, were selected on the basis of convenient sampling method. Adults (>18 years) consenting for randomised trials and having either unilateral direct or indirect inguinal hernia were included. They were randomly chosen for Lichtenstein's or TEP repair and the results were compared on the basis of the following outcome measures: 1) Duration of surgery (In min.), 2) Postoperative pain (In days), 3) Length of hospital stay (In days), 4) Post-operative complications like seroma, scrotal oedema, urinary retention, wound infection, 5) Cost comparison, 6) Recurrence rate. RESULTSThe outcomes were evaluated and compared with standard published literature. The mean duration of surgery for Lichtenstein's repair was 58.5 minutes whereas for TEP was 74.6 minutes. Duration of post-operative pain was more (2.9 days) for open repair than 1.3 days for TEP repair. Post-operative stay was longer (5.1 days) for open repair than 1.6 days for TEP. Minimal complications were noted in Laparoscopic TEP group (One incidence of seroma) as compared to the open Lichtenstein's hernioplasty (Postoperative seroma, scrotal oedema, urinary retention & wound infection). Recurrence was not seen with the open Lichtenstein's repair, which was seen in 1 patient of the laparoscopic TEP, which was managed by the Lichtenstein repair. However, TEP repair was approximately Rs. 4000 more expensive than open Lichtenstein repair. TEP repair, though expensive, is superior with regard to reduced post-operative pain, reduced hospital stay and minimal complications, when compared to Lichtenstein's repair. CONCLUSIONThe present study is a comparison of the effectiveness and complications of the Lichtenstein's tension-free repair and the Total Extraperitoneal (TEP) Repair. All the patients were carefully monitored from the time of admission till discharge, and the parameters pertaining to the study noted. We found that there is a marked reduction in post-operative pain in laparoscopic hernia repair compared to hernioplasty. Post-operative stay is less in TEP repair. Laparoscopic hernia repair is quite expensive compared to hernioplasty. Despite the fact that TEP is a demanding procedure, it may be performed efficiently with an acceptable operating time and a low complication rate. Although there is a very long learning curve for Laparoscopic TEP, but still it is a preferred technique for the management of inguinal hernia repair in an experienced hand.

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Prospective Randomized Study Comparing Laparoscopic and Open Tension-free Inguinal Hernia Repair with Shouldice’s Operation

Cited by 115 publications

References 3 publications

Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

A Comparative Study of Laparoscopic Tep and Open Lichtenstein’s Tension-Free Hernia Repair: A Single Surgical Unit Experience

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