DOI: http://dx.doi.org/10.18203/2349-2902.isj20200503

Prospective comparative study of laparoscopic totally extraperitoneal versus Lichtenstein’s tension free open meshplasty for management of inguinal hernia

Digant A. Patel, Govardhan N. Vaghasiya, Jagrutkumar R. Patel

Abstract


Background: Since the advent of minimal access surgery, its application has been widespread starting from appendectomy to complex intestinal surgeries carried out laparoscopically. But hernia surgery is a major debatable section, to compare it with the commonly performed gold standard Lichtenstein repair. First laparoscopic transabdominal preperitoneal and then totally extra peritoneal (TEP) repair came into existence. In today’s era of extended TEP repair laparoscopic TEP repair has emerged to be gold standard.

Methods: This is a prospective cohort study including 40 cases of Lichtenstein open meshplasty, against minimally invasive laparoscopic TEP procedure were compared. Patients operated in our department between January 2010 and September 2010 were included after consent and assessment. Procedures were carried out according to standard guidelines, and results compared for technical details, cosmesis, intra or post-operative complications, analgesia requirement, hospital stay, recovery and follow up and all results were analyzed.

Results: Operative time was less by 2 minutes, hospital stay less by 1 day, return to work earlier by nearly 20 days for strenuous work, analgesia requirement less for laparoscopic extra peritoneal repair.

Conclusions: Study showed that if the period of learning curve has been eliminated than an experienced surgeon performs laparoscopic procedure with better patient satisfaction, less hospital stay, faster recovery and earlier return to work with less operative time, analgesic consumption, and complication.


Keywords


Inguinal hernia, Laparoscopic totally extra peritoneal, Lichtenstein repair

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References


McIntosh E. Cost–utility analysis of open versus laparoscopic groin hernia repair: results from a multicentre randomized clinical trial. Brit J Surg. 2001;88(5):653-61.

Lau WY. History of treatment of groin hernia. World J Surg. 2002;26(6):748-59.

Wright AJ, Gardner GC, Fitzgibbons RJ. The Bassini repair and its varients. In Fitzgibbons RJG, A.G., ed. Nyhus and Condon’s hernia. Philadelphia: Lippincott Williams and Willkins; 2002: 105-114.

MRC Laparoscopic Groin Hernia Trial Group. Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet. 1999;354(9174):185-90.

Liem MS, Van Der Graaf Y, Van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS, et al. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med. 1997;336(22):1541-7.

Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989;157(2):188-93.

Lichtenstein IL, Shore JM. Exploding the myths of hernia repair. Am J Surg. 1976;132:307-15.

Arregui ME, Navarrete J, Davis CJ, Castro D, Nagan RF. Lap Aroscopic Inguinal Herniorrhaphy: Techniques and Controversies. Surg Clini North Am. 1993;73(3):513-27.

McKernan JB. Prosthetic inguinal hernia repair using a laparoscopic extraperitoneal approach. InSeminars in laparoscopic surgery. Sage CA: Thousand Oaks, CA: Sage Publications; 1994: 116-122.

Palanivelu C. Laparoscopic TEP repair- Operative manual of laparoscopic surgery- Coimbatore - Gem Digestive diseases foundation. 2004: 99-117.

Chowbey PK. Endoscopic repair of abdominal wall hernias. First edition. New Delhi: Byword Viva Publishers Pvt. Ltd; 2004.

Bolognini S, Orsini V, Grandinetti PP, Pata F, Sacco R. Lichtenstein vs. Rutkow-Robbins technique in the treatment of primary inguinal hernia. Analysis of the long term results. Ann Ital Chir. 2006;77:51-6.

Salcedo-Wasicek MC, Thirlby RC. Postoperative course after inguinal herniorrhaphy. A case-controlled comparison of patients receiving workers' compensation vs patients with commercial insurance. Arch Surg. 1995;130:29-32.

Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005;92:795-801.

Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc. 2005;19:188-99.

Mayo clinic. Mayo clinic on chronic pain. 2nd edition. 2002:1-210.

Payne JH Jr, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J. Laparoscopic or open inguinal herniorrhaphy? A randomized prospective trial. Arch Surg. 1994;129:973.

Sondenaa K, Nesvik I, Breivik K, Korner H. Long-term follow-up of 1059 consecutive primary and recurrent inguinal hernias in a teaching hospital. Eur J Surg. 2001;167:125-9.

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.

Eklund A, Rudberg C, Leijonmarck CE, Rasmussen I, Spangen L, Wickbom G, et al. Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair. Surg Endosc. 2007;21(4):634-40.

The EU Trialists Collobration. Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg. 2002;235:322-32.

Sakorafas GH, Halikias I, Nissotakis C, Kotsifopoulos N, Stavrou A, Antonopoulos C, Kassaras GA. Open tension free repair of inguinal hernias; the Lichtenstein technique. BMC Surg. 2001;1(1):3.

Gokalp A, Inal M, Maralcan G, Baskonus I. A prospective randomized study of Lichtenstein open tension-free versus laparoscopic totally extraperitoneal techniques for inguinal hernia repair. Acta chirurgica Belgica. 2003;103(5):502-6.

Vidović D, Kirac I, Glavan E, Filipović-Čugura J, Ledinsky M, Bekavac-Bešlin M. Laparoscopic totally extraperitoneal hernia repair versus open Lichtenstein hernia repair: results and complications. J Laparoendo Adv Surg Tech. 2007;17(5):585-90.

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

Feliu X, Jaurrieta E, Viñas X, Macarulla E, Abad JM, Fernández-Sallent E. Recurrent inguinal hernia: a ten-year review. J Laparoendo Adv Surg Tech. 2004;14(6):362-7.

Mahon D, Decadt B, Rhodes M. Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc. 2003;17:1386-90.

Sandbichler P, Gstir H, Baumgartner C, Furtschegger A, Egender G, Steiner E. Laparoscopic surgery of inguinal hernia by transperitoneal implantation of an artificial mesh. Technique and early results. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen. 1994;65(1):64-7.

Bittner R, Sauerland S, Schmedt CG. Comparison of endoscopic techniques vs Shouldice and other open nonmesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc. 2005;19:605-15.

McCormack K, Wake B, Perez J, Fraser C, Cook J, Vale L, et al. Systematic Review of the Clinical Effectiveness and Cost-Effectiveness of Laparoscopic Surgery for Inguinal Hernia Repair. BMJ. 2003: 326, 578.

Tamme C, Scheidbach H, Hampe C, Schneider C, Köckerling F. Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc Other Intervent Tech. 2003;17(2):190-5.

Schneider BE, Castillo JM, Villegas L, Scott DJ, Jones DB. Laparoscopic totally extraperitoneal versus Lichtenstein herniorrhaphy: cost comparison at teaching hospitals. Surg Laparosc Endosc Percutaneous Tech. 2003;13(4):261-7.

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