Comparative Study between Lichtenstein Repair and Trans Abdominal Pre Peritoneal Repair of Inguinal Hernia (TAPP)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Prof. Dr./Adel Faheem Ain-shoka ◽  
Dr/Mohamed Ibrahim Hassan ◽  
General Dr./Khaled Abdel-Aziz Elkholy ◽  
Ahmed Wahid Said Mohamed Matter
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Statistical Difference ◽  
Laparoscopic Group ◽  
Open Group ◽  
Lichtenstein Repair ◽  
Significant Statistical Difference ◽  
Post Operative Pain ◽  
Significant Difference

Abstract Background Inguinal hernia repair is one of the most widely performed surgical procedure. Among the techniques used, the open Lichtenstein repair is still the most widely performed. However, in the last decade there has been an increased interest in the laparoscopic approach for inguinal hernia repair, mainly represented as the trans-abdominal pre- peritoneal (TAPP) technique. As described in recent studies, TAPP approach entails the benefits of minimally invasive surgery, such as less pain and early recovery. Objective s: This study aims to compare between lichtenstein repair of inguinal hernia and trans-abdominal pre-peritoneal repair of inguinal hernia (TAPP) as regard their hospital stay, cost, intra-operative & post-operative complications and short term recurrence. Patients and Methods Our study was carried out on (50) male patients with inguinal hernia, 25 patients underwent laparoscopic TAPP repair and 25 patients underwent open Lichtenstein repair. We found a highly significant difference of laparoscopic TAPP Repair in decreasing post-operative pain than in open repair. Results Comparative study between the 2 groups revealed non-significant difference as regards age and sex of the patients. Comparative study between the 2 groups revealed non-significant difference as regards all socio-demographic data. Comparative study between the 2 groups revealed non-significant difference as regards type and side of hernia. Comparative study between the 2 groups revealed; highly significant increase in operative duration in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Comparative study between the 2 groups revealed; highly significant decrease in post-operative pain score and post-operative hospital stay; in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Comparative study between the 2 groups revealed; highly significant decrease in intra-operative complications in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Conclusion Our study showed that laparoscopic TAPP approach for inguinal hernia repair reduces early post-operative pain. Furthermore, it is related to less complications, although it takes a longer operative time and higher cost.

Comparative Study between Laparoscopic versus Open Hernioplasty in Repair of Unilateral Non Recurrent Inguinal Hernia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham Hassan Wagdy ◽  
Mostafa Abdo Mohamed ◽  
Ahmed Khalil ◽  
Osama Mohamed Ali El Ebiedy
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Statistical Difference ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Open Group ◽  
Recurrent Inguinal Hernia ◽  
P Value ◽  
Significant Statistical Difference

Abstract Background Laparoscopic surgery has led to many changes in the management of surgical patients and significantly reduced the incidence of complications associated with open surgical procedures 1. At present, laparoscopic hernia repair has gained clinical significance in patients with bilateral or recurrent hernia. 2 Objectives The aim of this study is to compare open hernioplasty and laparoscopic hernia repair in unilateral non recurrent inguinal hernia. The present study will be performed on 30 patients to compare the effectiveness of laparoscopic hernia repair and open hernioplasty and to assess the intra operative and post-operative complications, duration of surgery, hospital stay, postoperative morbidity, recurrence and patient satisfaction. Patients and Methods . Comparative studies on 30 patients were classified according the type of operative technique into 2 groups: Group A patients underwent laparoscopic technique (15 patients), group B patients underwent open technique (15 patients) to evaluate and compare the open and laparoscopic techniques in unilateral non recurrent inguinal hernia repair as regard operative time,post operative pain, hospital stay, urine retention, parathesia, numbness, seroma,, wound infection and recurrence Results Our study revealed highly significant increase in operative time in laparoscopic group; compared to open group of patients; with highly significant statistical difference (p value < 0.0001), highly significant decrease in post-operative pain score in laparoscopic group; compared to open group of patients; with highly significant statistical difference. (p value = 0.00434),highly significant decrease in postoperative hospital stay in laparoscopic group; compared to open group of patients; with highly significant statistical difference. (p value = 0.000003), significant decrease in post operative parathesia and numbness in laparoscopic group; compared to open group of patients; (p value =0.000414),highly significant decrease in post-operative urine retention in laparoscopic group; compared to open group of patients; with highly significant statistical difference (p value= 0.000267). Conclusion The laparoscopic technique is superior to the open technique of tensionfree repair, in terms of immediate post-operative complications and delayed pain and paresthesia also in terms of safety.

scholarly journals Laparoscopic versus open mesh repair of unilateral inguinal hernia: a comparative study

2017 ◽  
Vol 4 (3) ◽  
pp. 921
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Kaarthik V. P. ◽  
Prabu Shankar S.
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Group ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Unilateral Inguinal Hernia ◽  
Laparoscopic Inguinal Hernia ◽  
Post Operative Pain ◽  
Significant Difference

Background: Inguinal hernia repair is now one of the most commonly performed general surgical procedures in practice. Laparoscopic inguinal hernia repair was started in year 1999 and since then has gained popularity over the last 2 decades. The introduction of a laparoscopic technique has sparked a debate in the literature over the superiority of this method versus open repair. Even though for bilateral and recurrent inguinal hernias, laparoscopic approach is recommended, there is not enough literature to recommend its routine use in unilateral inguinal hernia repair.Methods: A randomised prospective study was conducted at a tertiary care teaching hospital, comparing both Laparoscopic inguinal hernia repair and lichensteins tension free mesh repair as treatment modalities for unilateral inguinal hernia. Total number of patients in the study group was 60. Patients who were willing for the study were selected for the open or laparoscopic procedure in a randomised way. Open procedure was done by 2 senior surgeons and laparoscopic procedure was performed by 2 other senior surgeons at associate professor designation. Various parameters like the complication rate, post-operative pain, post-operative stay and time to return to work were analysed.Results: Out of the 60 patients, 30 patients underwent open inguinal hernia repair and another 30 patients underwent Laparoscopic inguinal hernia repair. The mean age group was 46.73 in open surgery group and 42.10 in laparoscopic group. 23.3% of the patients in open hernioplasty developed seroma, hematoma in the post-operative period. Whereas 10% had seroma collection in laparoscopic group. No incidence of recurrence in both the groups. No significant difference in pain score between both the groups during immediate post-operative period on POD 0, however there was significant difference in pain score on POD 3 (mean pain in open group 4.13 and lap group 2.87) and POD 7(mean pain in open group 2.90 and lap group 1.23). Mean duration of stay in hospital for open hernioplasty was 7.8 days and for Laparoscopic hernioplasty was 3.07 days. Mean duration of return to work in open hernioplasty was 14.37 days and in laparoscopy group was 9.13 days.Conclusions: There are potential benefits for laparoscopic inguinal hernia repair over lichtenstein’s repair for unilateral inguinal hernias in terms of post-operative pain, hospital stay and early return to work.

scholarly journals Desarda’s versus Lichtenstein technique of inguinal hernia repair

2017 ◽  
Vol 5 (1) ◽  
pp. 92
Author(s):  
Obaid Syed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Complication Rate ◽  
Mesh Repair ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

scholarly journals A prospective comparative study of outcome between open lichtenstein versus laparoscopic repair of inguinal hernia

2021 ◽  
Vol 9 (5) ◽  
pp. 1417
Author(s):  
Sushila Choudhary ◽  
Hitesh Soni ◽  
Jagdish M. Mehta ◽  
Saurabh Kalia
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Open Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Usual Activity ◽  
Time Duration ◽  
Post Operative Pain ◽  
Hospital Stays

Background: Laparoscopic hernia repair is technically difficult and has long learning curve than open repair. Moreover, with increased cost of procedure do patient really get benefited in terms of intraoperative time duration, post-operative pain and complications, length of hospital stays, and time taken to return to usual activity needs to be studied.Methods: In this prospective observational study of 100 patients including unilateral, bilateral, direct and indirect inguinal hernia and excluding obstructed and strangulated hernia, 61 patients underwent open repair and 39 patients underwent laparoscopic hernia repair. Pain analysis was done with visual analogue scale. Unpaired student T test and Chi square test used (p<0.05).Results: Baseline characteristics age, sex of the two groups were similar. Mean operative time in laparoscopic group was 105.38±35.13 minutes and in open group was 79.95±31.12 minutes (p<0.001). There was statistically significant difference in mean pain score of laproscopic verses open techniques (p<0.001). Urinary retention was the most common post-operative complication in both groups but was statistically not significant. Mean hospital stay in laparoscopic group was 1.56±0.50 days and in open group was 1.9±0.50 days (p-0.002). Mean time taken to return to usual activity in open repair was 41.10±27.15 days and in laparoscopic group was 16.23±6.37 days (p-0.001).Conclusions: This study showed that in laparoscopic repair of inguinal hernia patients have less post-operative pain, shorter hospital stays and early return to work. However, the laparoscopic technique had longer operative time duration.

scholarly journals Comparison of Laparoscopic VS Open Inguinal Hernioplasty in a Tertiary Care Hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 17-22
Author(s):  
Md Mahfuzul Momen ◽  
Ashok Kumar Sarker ◽  
Deb Prosad Paul ◽  
Debasis Das ◽  
Sonia Akhter ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Laparoscopic Group ◽  
Open Group ◽  
Care Hospital ◽  
Laparoscopic Hernioplasty ◽  
The Mean

Background: Inguinal hernia repair is one of the most common surgical procedures in Bangladesh. The option of surgical treatment remains controversial. Laparoscopic hernia repair has all the benefits of a tension free repair. We aimed to compare postoperative outcome and cost between laparoscopic and open inguinal hernia repair. Objective: This study was conducted with an objective to compare the effectiveness of each procedure and complications if any. Materials and Methods: Fifty cases of inguinal hernia admitted in the tertiary care center were selected by nonprobability (purposive) sampling method. All patients with uncomplicated hernia treated by open or laparoscopic method were included. The age/sex, incidence, mode of presentation, surgical treatment and postoperative complications were evaluated and compared with standard published literature. Results: Postoperative wound infection developed in three cases of open hernioplasty and one case in laparoscopic surgery. Hematoma and seroma at the operated site were found in one case of laparoscopic hernioplasty and in two cases of open hernioplasty. Orchitis was more prevalent in the laparoscopic hernioplasty patient with incidence among two cases as compared to one in open group. The mean duration of hospitalization was 59.62±6.11 hours in case of laparoscopic hernioplasty while 53.33±8.26 hours in open hernioplasty. The mean duration of procedure was 72.33 minutes in laparoscopic group while 64.62 minutes in open surgery. The mean cost for the laparoscopic repair group was around taka 63000/= whereas in the open group it was around 42000/= only with significant difference. Prolonged groin pain was seen in four cases in open group as compared to one in laparoscopically operated cases. Conclusion: There were less post-operative complications in the laparoscopic group. J Enam Med Col 2020; 10(1): 17-22

scholarly journals Prospective Randomized Blinded Study to Compare Laparoscopic and Open Inguinal Hernioplasty

2020 ◽  
Vol 3 (1) ◽  
pp. 149-154
Author(s):  
Mohd. Ilyas ◽  
Venkat Vaijnath Cholleti
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Randomized Study ◽  
Early Assessment ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Study Results ◽  
Significant Difference

Background: Hernia is one of the common surgical problems. Repair of inguinal hernia is one of the commonest surgical procedures worldwide, irrespective of country, race or socio-economic status and constitutes a major health-care in every country. Subjects and Methods: This is a randomised prospective study done over 50 patients in the department of general surgery of Kamineni hospitals, LB Nagar, Hyderabad during the period of October 2010 to August 2012 with the aim to compare laproscopic inguinal hernia repair and open inguinal hernia repair with regards to post-operative pain, surgical site infections, hospital stay and time taken to return to work, by a randomized study. Results: Compare laparoscopic and mesh inguinal hernia repairs, there is no significant difference in early assessment with regards to duration of operation, post-operative pain, analgesic requirements on the day of surgery and first post-operative day, hospital stay, return to daily and normal activities and post-operative complications. Conclusion: Laparoscopic mesh hernioplasty still remains to be validated with larger number of patients and longer duration of follow up.

scholarly journals P163 ROLE OF THE LAPAROSCOPIC APPROACH IN EMERGENT INGUINAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joan Ricard Soler Frias ◽  
Anabel García León ◽  
Luis Tallon-Aguilar ◽  
Jose Tinoco González ◽  
Alejandro Sánchez Arteaga ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Elective Surgery ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Reoperation Rate ◽  
Open Group ◽  
Open Approach

Abstract Aim Analyze the evolution of the laparoscopic approach in emergent inguinal hernia repair at our center. Material and Methods Retrospective review of patients with emergent inguinal hernia repair in our center from January 2011 to June 2020. Demographic, clinical and postoperative data were analyzed as well as the evolution of the laparoscopic approach. Results 385 patients with incarcerated/strangulated inguinal hernia were registered. 58.96% were men, with a median age of 71. Of those, 22 patients (5.71%) were treated by laparoscopic approach and 363 (94.29%) by open approach. The open approach had a longer median hospitalization (4.82 vs 1.66 days), higher rate of surgical wound infection (5.51% vs. 0%), higher reoperation rate (3.31% vs 0%) and higher incidence of respiratory complications (1.97% vs 0%). 1 patient (4.54%) with laparoscopic approach required intestinal resection vs 48 patients (13.22%) of the open group, with a dehiscence rate of 0% vs 4.76% respectively. Mortality rate was 0% for the laparoscopic group and 2.75% in the open group. In the last 18 months, 28.98% of urgent hernias repaired have been performed laparoscopically, while previously from 2011 to 2017 only 0.95%, due to the learning curve obtained in elective surgery where the laparoscopic approach has had a major development in the last 3 years. Conclusions Despite the evident patient selection bias because the approach choice by the surgeon in emergent inguinal hernia repair, laparoscopic approach is feasible and has lower morbidity-mortality compared to open approach in our center. In specialized centers this may be a treatment option for selected patient groups.

scholarly journals LAPAROSCOPIC TRANS-ABDOMINAL PREPERITONEAL VERSUS LICHTENSTEIN REPAIR OF INGUINAL HERNIA: A COMPARATIVE STUDY.

2019 ◽  
Vol 26 (07) ◽  
pp. 1151-1155
Author(s):  
Munawar Jamil ◽  
Khurram Niaz ◽  
Fatima Tahir ◽  
Humaira Sobia
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Return To Work ◽  
Hospital Stay ◽  
Operation Time ◽  
Laparoscopic Group ◽  
Lichtenstein Repair ◽  
Acute Postoperative Pain ◽  
Stay Time

Objectives: To compare Laparoscopic transabdominal preperitoneal (TAPP)  to open Lichtenstein inguinal hernia repair for operation time, acute postoperative pain, complications, hospital stay, time to return to work to find out which has better outcome. Study Design: A prospective randomised controlled trial. Setting: QAMC/BVH Bahawalpur; Pakistan. Period: July 2017 to June 2018. Methodology: It included 50 patients, 32 in Lichtenstein group and 18 in TAPP group above the age of 18 years. Operation time, acute postoperative pain, complications, hospital stay, time to return to work were compared in two groups. Data analysis was done on SPSS 23 version. Results: Mean age of patients were 45±9.79 and 44.95±9.82 in Lichtenstein and laparoscopic group, 96% were male. Operation time was 37.96±13.66 vs. 48.77±9.99 (Min), hospital stay 2.28±0.79 vs.1.55±0.63 (Days), time to return to work 13.20±4.75 vs.10.47±3.59 (Days) in Lichtenstein and laparoscopic group respectively. Pain score was 6.1±1.9 vs. 5.2±0.94 in Lichtenstein and laparoscopic group. In immediate complications haematoma 6.25% vs. 0%, seroma 3.12% vs. 11.11%, wound infection 9.37% vs.5.55%, visceral injury 0% vs. 5.5% in Lichtenstein to laparoscopic group respectively. In long term complications chronic pain 28.12% vs.11.11%, recurrence 3.12% vs.0%, port site hernia 0% vs. 5.55%, numbness 9.37% vs. 0% in Lichtenstein and Laparoscopic group respectively. Mortality was nil in both groups. Conclusion: Although there is insignificant difference in complication rate, Laparoscopic hernia repair is better than Lichtenstein repair in terms of less postoperative pain, less hospital stay and early return to work.

scholarly journals A Comparative Study of Electrocautery Versus Cold Scalpel For Skin Incision In Inguinal Hernia Repair

2017 ◽  
Vol 14 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Meraj Alam Ansari ◽  
S. M. Mishra ◽  
B. D. Baskota
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Inguinal Hernia Repair ◽  
College Teaching ◽  
Skin Incision ◽  
Skin Wound ◽  
Wound Complications ◽  
P Value ◽  
Post Operative Pain

Introduction: Electrocautery has been widely used except for the skin incisions; this is because of the fear of scarring of skin, post operative pain, poor wound healing and wound infection in view of devitalisation of tissues. Although still not very popular, yet the use of diathermy instead of scalpel for making skin incision and underlying tissue dissection is gradually gaining wide acceptance. The purpose of this study was to compare the scalpel incision with electrocautery incision over skin in patients undergoing hernia repair.Aims and Objectives: To compare the skin wound made by the diathermy and scalpel with a view in; intraoperative incision time, post operative pain, requirement of analgesia and the quality of wound healing.Material and Methods: This is hospital based comparative study, undergone elective inguinal hernia repair in the department of general surgery at Nepalgunj medical college teaching hospital, Kohalpur from the period of July 2015 to January 2016. Group A, contained 30 patients who underwent skin incision with scalpel and Group B, also contained 30 patients who underwent skin incision with electrocautery. These groups were compared and statistical analysis using SPSS (version 20) was done and p value 0.05 was taken as significant.Results: Compared with a scalpel incision, cutting diathermy resulted in significantly shorter incision time (p <0.002). The two groups did not differ in relation to post operative pain and the post operative analgesics requirements. The postoperative complications viz, seroma and purulent collections were in both the groups though the hematoma collection was seen more in scalpel skin incision.Conclusion: Skin incision made by cutting diathermy was less time taking and there was no appreciable differences in postoperative pain, the requirements of analgesia and the rate of wound complications like seroma, and purulent collection, though the hematoma was seen more in scalpel skin incision. So the use of diathermy for making skin incision is as safe as the use of scalpel in patients undergoing inguinal hernia repair.  JNGMC Vol. 14 No. 1 July 2016, Page: 14-17 

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