Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

Abstract

Background: Laparoscopic herniorrhaphy has emerged as a recognized operative method for inguinal hernia repair. This study compared the short-term results of two tension-free methods of repair: totally extraperitoneal (TEP) laparoscopic patch repair and the open Lichtenstein mesh technique.Methods: A total of 1513 men from 11 hospitals who presented with a primary unilateral inguinal hernia were randomized to one of the two methods. Operating time, short-term complications, reoperations, postoperative pain, consumption of analgesics, sick leave and time to resumption of normal physical activities were recorded. Results: Some 1371 of the 1513 men underwent surgery, 665 in the TEP group and 706 in the Lichtenstein group. The median duration of operation was 55 min for both procedures and 91·0 per cent of the patients in both groups were discharged on the day of operation. Patients in the TEP group experienced less postoperative pain (P < 0·001), consumed fewer analgesics (P < 0·001), had a shorter period of sick leave (7 versus 12 days; P < 0·001) and a shorter time to resumption of normal physical activity (20 versus 31 days; P < 0·001). Conclusion:The TEP technique took no longer to perform, and was associated with less postoperative pain, a shorter period of sick leave and a faster recovery, compared with open Lichtenstein hernia repair.

A study of laparoscopic total extraperitoneal endoscopic hernioplasty in cases of inguinal hernia - an experience of a tertiary care centre

“…In study conducted by Eklund et al, mean duration at which patient returned to routine work was 20 days. 7,9,[14][15][16] In present study mean duration at which patient returned to work is comparable to above mentioned studies. The patients who undergo laparoscopic surgery are able to resume routine early when compare open surgery.…”

“…In study conducted by Eklund et al, 91% of patients out of 665 patients were discharged on same post-operative day. 3,7,14 In the studies mentioned above majority of patients were discharged on same post-operative. So this will reduce the burden on hospital with regards to sickbeds which is important in country like India.…”

Stoppa’s modified, open preperitoneal prolene mesh hernioplasty: a critical analysis of operative outcome in 70 cases

“…Comparing this to the laparoscopy preperitoneal repair where the learning curve is steep with estimated 40-50 cases as reported in articles. [22][23][24] We believe that GPRVS can be practiced safely and effectively even by not so experienced surgeons.…”

Laparoscopic Tep Versus Open Hernioplasty: A Comparative Study of Extraperitoneal Tension Free Mesh Repairs in Inguinal Hernia

“…At present, the laparoscopic repair of hernias finds its clinical niche in patients with bilateral or recurrent hernias or in patients with unilateral hernia who desire a minimal period of postoperative disability. [16] Open hernia repair requires an incision at the point of maximum weakness, dividing of muscle and then suturing to repair the defect. This damage must heal before the wound become comfortable.…”