A comparative study of laparoscopic technique versus open repair for inguinal hernia
DOI:
https://doi.org/10.18203/2349-2902.isj20204116Keywords:
Inguinal hernia, Lichtenstein’s repair, Laparoscopic hernioplastyAbstract
Background: The repair of inguinal hernias has seen an evolution over the past few decades and more research on the same is still underway. Though laparoscopy has gained widespread acceptance in today’s era of surgery, there is still a debate between laparoscopic and open hernia mesh repair.
Methods: A randomized prospective study was conducted at a tertiary care teaching hospital to compare laparoscopic hernioplasty and Lichtenstein’s open mesh repair. The study consisted of 70 subjects with unilateral or bilateral inguinal hernia and they were randomly allocated into either group. Various parameters like duration of surgery, intra and post-operative complications, post-operative pain, recurrence, stay in the hospital and resumption of daily activities were compared.
Results: Out of the 70 patients, 35 underwent laparoscopic hernioplasty and 35 underwent open hernia repair. The mean operative time for laparoscopic hernioplasty (unilateral 63.44mins, bilateral 123.80mins) was greater than open hernioplasty (unilateral 47.35mins, bilateral 90.42 mins). Post-operative complications, like wound infection, seroma formation and urinary retention were noted more in the open hernioplasty group. The mean pain score for laparoscopic hernia repair was lower than open hernia repair on postoperative day 3 and 7. The average duration of hospital stay was 3.5 days in laparoscopy group and 6 days in open group. The mean duration for resumption of daily activities was 4.8 days following laparoscopic hernioplasty and 8.1 days following open hernioplasty.
Conclusions: Laparoscopic hernioplasty is more beneficial than Lichtenstein’s open hernia mesh repair as it is safer, with faster recovery, lesser post-operative complications and reduced morbidity.
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References
Bhandarkar DS, Shankar M, Udwadia TE. Laparoscopic surgery for inguinal hernia: Current status and controversies. J Minim Access Surg. 2006;2(3):178-86.
Hamza Y, Gabr E, Hammadi H, Khalil R. Four-arm randomized trial comparing laparoscopic and open hernia repairs. Int J Surg. 2010;8(1):25-8.
Sudarshan PB, Sundaravadanan BS, Kaarthik VP, Pabu Shankar S. Laparoscopic versus open mesh repair of unilateral inguinal hernia: a comparative study. Int Surg J. 2017;4:921-5.
Rathod CM, Karvande R, Jena J, Ahire MD. A comparative study between laparoscopic inguinal hernia repair and open inguinal hernia repair. Int Surg J. 2016;3:1861-7.
V Singh, U De. Laparoscopic Mesh versus Open Mesh Repair of Inguinal Hernia. An Experience from West Bengal, India. Int Surg J. 2008;20(1).
McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785.
Hetzer FH, Hotz T, Steinke W, Schlumpf R, Decurtins M, Largiader F. Gold standard for inguinal hernia repair: Shouldice or Lichtenstein?. Hernia. 1999;3(3):117-20.
Neumayer L, Hurder GA, Jonasson O, Fitzgibbons 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.
McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785.
Leibl B, Daubler P, Schwarz J, Ulrich M, Bittner R. Standardised laparoscopic (TAPP) versus shouldice repair of inguinal hernia. results from a prospective randomised and controlled trial. Chirurg. 1995; 66:895-8.
Barkun JS, Wexler MJ, Hinchey EJ, Thibeault D, Meakins JL. Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomised controlled trial. Surg. 1995;118:703-10.
Vogt DM, Curet MJ, Pitcher DE, Martin DT, Zucker KA. Preliminary results of a prospective randomised trial of laparoscopic only versus conventional inguinal herniorrhaphy. Am J Surg. 1995;169:84-90.
Hauters P, Meunier D, Urgyan S, Jouret JC, Janssen P, Nys JM. Prospective randomised study compar- ing laparoscopy and shouldice technique in the treatment of unilateral inguinal hernia. Ann Chir. 1996;50:776-81.
Wright DM, Kennedy A, Baxter JN, Fullarton GM, Fife LM, Sunderland GT, et al. Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial. Surgery. 1996;119:552-7.
Gordon A, Gray A, et al. Randomised controlled trial of laparoscopic versus open repair of inguinal hernia: early results. Brit J Med. 1995;311:981-5.
Horeyseck G, Roland F, Rolfes N. Tension-free repair of inguinal hernia: laparoscopic (TAPP) versus open (lichtenstein) repair. Chirurg. 1996; 67(10):1036-40.
