Comparison between lichtenstein and laparoscopic transabdominal preperitoneal repair of adult inguinal hernias – A randomized controlled study

Abstract

Background: Lichtenstein tension free repair is the gold-standard technique amongst the open procedures performed for inguinal hernia repair. Advanced laparoscopic techniques are also now being widely used one of which is the transabdominal preperitoneal (TAPP) inguinal hernia repair. In this study Lichtenstein was compared with TAPP for adult inguinal hernia repair. Objective: To compare the two procedures in terms of operative time taken, intra-operative complications, post-operative complications, duration of hospital stay and recurrences. Material and Methods: A randomized controlled study was carried out in the Department of surgery, RMCH, Bareilly, Uttar Pradesh from 01 Nov 2019 to 31 Oct 2020. Hundred and twelve adult inguinal hernia patients were included and randomly allotted to Lichtenstein and TAPP repair. All data was statistically assessed using SPSS version 23. Results: Operative time of Lichtenstein and TAPP was 42.05±10.03 and 67.25±6.05 minutes respectively. Visual analogue score (VAS) for pain at 24 hours in Lichtenstein and TAPP group was 4.35±1.1 & 2.28±0.94 respectively and at 72 hours was 3.41±1.09 and 1.37±0.72 respectively. Wound infection was present in 4 (7.14%) patients of the Lichtenstein group no infection was observed in the TAPP group. There was no significant difference found in the groups when compared for post-operative hematoma, seroma and neuralgia. Post-operative hospital stay was significantly lower in the TAPP group (mean ± SD: 2.71 ± 0.52 days) as compared to Lichtenstein group (mean ± SD: 6.14 ±1.2 days). One patient in Lichtenstein group had recurrence on three months of follow-up.