A comparative study between laparoscopic inguinal hernia repair and open inguinal hernia repair

Chetan M. Rathod; Rajiv Karvande; Jhulan Jena; Manoj Kumar D. Ahire

doi:10.18203/2349-2902.isj20163044

Authors

Chetan M. Rathod Department of Surgery,Lokmanya Tilak Medical College,Sion,Mumbai,Maharashtra, India
Rajiv Karvande Department of Surgery,Lokmanya Tilak Medical College,Sion,Mumbai,Maharashtra, India
Jhulan Jena Department of Surgery,Lokmanya Tilak Medical College,Sion,Mumbai,Maharashtra,India
Manoj Kumar D. Ahire Department of Surgery,Lokmanya Tilak Medical College,Sion,Mumbai,Maharashtra,India

DOI:

https://doi.org/10.18203/2349-2902.isj20163044

Keywords:

Inguinal hernia repair, Laparoscopic hernioplasty, Open hernioplasty

Abstract

Background: Repair of inguinal hernia by the laparoscopic hernioplasty over open hernioplasty is preferable in terms of less postoperative pain and morbidity, wound complications, postoperative pain, early resumption of activity and work and better cosmetic results. Laparoscopic hernioplasty by totally extraperitoneal repair (TEP) technically eliminates the hazards of intra operational injuries.

Methods: The study designed was an prospective, open labeled, randomized, comparative, two armed study during a period from December 2010–October 2012. After taking written consent from the patients were randomly allocated to two groups consisting 25 in each. Group OH were operated with open tension free Lichtenstein’s hernioplasty. Group TEP operated by laparoscopic totally extraperitoneal repair using mesh. Surgical variables and clinical outcomes were measured.

Results: During the study no major life threatening complications were reported in either group only peritoneal breach was encountered intraoperatively in the TEP group and the difference found to be significant (p value = 0.000). Post operatively necessity of drain was seen in 9 patients out of 30 in TEP group. There were three (12%) cases of immediate mesh displacement in TEP group but none in the OH group. It was observed that the mean time taken to complete a laparoscopic hernia repair was significantly higher (p value = 0.000) in TEP compared to open procedure. The postoperative pain score and need of analgesics, presence of surgical site infections were more in OH group compared to TEP group. The time taken for resumption of daily activities and work was earlier in patients treated with TEP compared to open surgery (p <0.005) and good significant cosmetic results was also observed with the same group only (p <0.00).

Conclusions: Laparoscopic hernia repair is safe and provide less postoperative morbidity in experienced hands compared to open hernia repair.

Metrics

Metrics Loading ...

References

Amid PK. Lichtenstein's Tension Free Hernioplasty. In: Mastery of Surgery chapter 176. 5th edition. Lippincott Williams and Wilkins's publications; 2007: 1932-1939.

Liem MS, van Duyn EB, Van der Graaf Y, Van Vroonhoven TJ. Cola Trail Group; Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Ann Surg. 2003;237(1):136-41.

Schirmer BD, Edge SB, Dix J, Hyser MJ, Hanks JB, Jones RS. Laparoscopic cholecystectomy: Treatment of choice for symptomatic cholelithiasis. Annals of surgery. 1991;213;6:665-77.

Neumayer L, Giobbie Hurder A, Jonasson O , Fitzgibbons R Jr, Dunlop D, Gibbs J , et al. Veterans Affairs Cooperative Studies Program 456 Investigators. Open mesh versus laparoscopic mesh repair of inguinal hernias. N Engl J Med. 2004;350(18):1819-27.

Lal P, Kajla RK, Chander J, Saha R, Ramteke V K. Randomized controlled study of laparoscopic total extra peritoneal versus open Lichtenstein's inguinal hernia repair. Surg Endosc. 2003;17(6):850-6.

Colak T, Akca T, Kanik A, Aydin S. Randomized clinical trail comparing laparoscopic totally extra peritoneal approach with open mesh repair in inguinal hernia. Surg Laparosc Endosc Percut Tech. 2003;13(3):191-5.

Sakorafas GH, Halikias I, Nissotakis C, Kotsiopoulos N, Stavrou A, Antonopoulos C, et al. Open tension free repair of inguinal hernias: the Lichtenstein technique. BMC Surg. 2001;1:3.

Rattner D, Michael Van Noord. Totally Extra peritoneal Inguinal Hernia Repair. In: Mastery of Surgery, Chapter 1743. Fifth edition. Lippincott, Williams & Wilkins Publications; 2007: 1905-1911

Chang C, Rege RV. Minimally Invasive Surgery. In: Sabiston Text Book of Surgery. 17th edition. Elsevier publications; 2004: 445- 470.

Jobe BA, Hunter JG. Minimally Invasive Surgery. In: Schwartz's Principles Of Surgery. 8th edition. Mc Graw publication; 2005: 379-402.

Darzi A. Principles of Laparoscopic Surgery. In: Bailey and Loves Short Practice of Surgery. Hodder Arnold Publications; 2004: 107-17.

Gainant A. Where does laparoscopy fit in the treatment of inguinal hernia in 2003?. J Chir (Paris). 2003;140(3):171-5.

Bringman S, Ramel S, Heikkinen TJ, Englund T, Westman B, Anderberg B. Tension free inguinal hernia repair: TEP versus mesh plug versus Lichtenstein: a prospective randomized controlled trial. Ann Surg. 2003;237(1):142-7.

Go PM. Overview of randomized trails in laparoscopic inguinal hernia repair. Semin Laparosc Surg. 1998;5(4):238-41.

Schrenk P, Woisetschlager R, Rieger R, Wayand W. Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal orShouldice technique for inguinal hernia repair. Br J Surg. 1996;83:1563-6.

Schwab JR, Beaird DA, Rams haw BJ, Franklin JS, Duncan TD, Wilson RA, et al. After 10 years and 1903 inguinal hernias, what is the outcome for laparoscopic repair? Surg Endosc. 2002;16(8):1201-16.

McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, et al. Laparoscopic surgery for inguinal hernia repair: systemic review of effectiveness and economic evaluation. Health Technol Assess. 2005;9(14):1-203.

Ramshaw BJ, Tucker JG, Conner T, Masson EM, Duncan TD, Lucas GW. A comparison of the approaches to laparoscopic herniorrhaphy. Surg Endosc. 1996;10(1):29-32.

Fujita F, Lahamann B, Otsuka K, Lyass S, Hiatt JR, Phillips EH. Qauntification of pain and satisfaction following laparoscopic and open hernia repair. Arch Surg. 2004;139(6):596-602.

Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs. laparoscopic extra peritoneal inguinal hernia repair in a mature surgical practice. Surg Endosc. 2004;18(2):221-7.

Pokorny H, Klinger A, Scheyer M, Fugger R, Bischof G. Postoperative pain and quality of life after laparoscopic and open inguinal hernia repair: results of a prospective randomized trail. Hernia. 2006;10(4):331-7.

Felix E, Scott S, Crafton B, Geis P, Duncan T, Sewell R, et al. Causes of recurrence after laparoscopic hernioplasty. A multicenter study. Surg Endosc. 1998;12:226-31.

Savarise MT, Simpson JP, Moore JM, Leis VM. Improved functional outcome and more rapid return to normal activity following laparoscopic hernia repair. Surg Endosc. 2001;15(6):574-8.

Maddern GJ, Rudkin G, Bessel JR, Devitt P, Balfour J. A comparison of laparoscopic and open hernia repair as a day surgical procedure. Surg Endosc. 1994;8(12):1404-8.

Filipi CJ, Gaston-Johansson F, McBride PJ, Murayama K, Gerhardt J, Cornet DA, et al. An assessment of pain and return to normal activity. Laparoscopic hernioplasty versus open tension free Lichtenstein's repair. Surg Endosc. 1996;10(10):983-6.

Gainant A. Where does laparoscopy fit in the treatment of inguinal hernia in 2003? Chir (Paris). 2003;140(3):171-5.

Udwadia TE. Inguinal hernia repair: The total picture. J Min Access Surg. 2006;2(3):144-6.