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

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.

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

QJM ◽

10.1093/qjmed/hcab097.013 ◽

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.

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Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20195944 ◽

2019 ◽

Vol 7 (1) ◽

pp. 24

Author(s):

Waleed Yusif El Sherpiny

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Group ◽

Routine Activities ◽

Group A ◽

Group B ◽

Open Hernia Repair ◽

Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

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Litigation claims following laparoscopic and open inguinal hernia repairs

Hernia ◽

10.1007/s10029-020-02173-y ◽

2020 ◽

Vol 24 (5) ◽

pp. 1113-1120

Author(s):

R. Varley ◽

C. Lo ◽

B. Alkhaffaf

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Vascular Injury ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Hernia Surgery ◽

Visceral Injury ◽

Inguinal Hernia Surgery ◽

The Uk

Abstract Purpose Groin hernia repair is the most frequently performed general surgical operation in the UK. Complications from laparoscopic and open repair are well recognised; however, potential differences are yet to be considered in relation to litigation. Methods Administrative data were obtained and analysed from the NHS Litigation Authority for inguinal hernia-related claims from 1995 to 2016. Claims identified as using an open or laparoscopic approach were compared. Results 880 claims were made, 760 had been settled. 88 laparoscopic and 241 open procedures were identified; 65% laparoscopic and 63% open hernia claims were found to be in favour of the claimant. Payouts totalled to 4.1GBP/4.8EUR/5.3USD million and 9.4GBP/11.0EUR/12.1USD million for laparoscopic (mean 82,824GBP/96,579EUR/106,453USD) and open (mean 66,796GBP/77,892EUR/85,852USD) approaches, respectively. The most common reasons for claim initiation were visceral/vascular injury (54%) in the laparoscopic group, and testicular complications or chronic pain (35%) in the open group. Additional procedures were necessary for 48% and 44% of laparoscopic and open claims, respectively. The highest average payouts were associated with visceral injury, (laparoscopic 116,482GBP/135,820EUR/149,715USD; open 199,103GBP/232,246EUR/255,905USD) and vascular injury (laparoscopic 88,624GBP/103,369EUR/113,892USD; open 64,460GBP/75,163EUR/82,870USD). Additional procedures resulted in an average payout of 93,352GBP/108,917EUR/120,008USD (laparoscopic) and 60,408GBP/70,506EUR/77,657USD (open). The most common additional procedures were corrective visceral/vascular repairs, orchidectomy and recurrent hernia repair. Conclusions The rate of litigation for clinical negligence in inguinal hernia surgery in the UK is increasing. Whilst there has been a recent increase in laparoscopic hernia repair claims, the volume and burden of claims related to open procedures remain greater.

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COMPARATIVE ANALYSIS OF THE RESULTS OF PLASTIC INGUINAL HERNIA LAPAROSCOPIC AND TRADITIONAL METHODS

BULLETIN OF SURGERY IN KAZAKHSTAN ◽

10.35805/bsk2021iv027 ◽

2021 ◽

pp. 27-31

Author(s):

Diyar Akhmet ◽

◽

Zhasulan Baimakhanov ◽

Erik Nurlanbayev ◽

Askar Matkerimov ◽

...

Keyword(s):

Inguinal Hernia ◽

Comparative Analysis ◽

Hernia Repair ◽

Hospital Stay ◽

Postoperative Period ◽

Laparoscopic Hernia Repair ◽

Traditional Methods ◽

Scientific Center ◽

Duration Of Hospital Stay ◽

Analgesic Therapy

Purpose of the study. Conduct a retrospective comparative analysis of the results of laparoscopic and traditional methods of inguinal hernia repair, patients treated at the surgical departments at “A.N. Syzganov National Scientific Center of Surgery”, Almaty, Kazakhstan. Materials and methods. In the period from January 2017 to December 2020 137 patients were operated at the “A.N. Syzganov National Scientific Center of Surgery” in a planned manner for inguinal hernia and all patients were divided into 2 main groups: operated by traditional methods and laparoscopic method. Results.The data of the analysis suggests that the laparoscopic method of hernioplasty has an advantage over the traditional methods. Conclusion. Based on a comparative analysis of the indicators of patients in both groups, it can be concluded that the duration of the operation for laparoscopic hernia repair is 92.3 minutes, significantly more than with traditional methods, which is 79.4 minutes. Despite this, the duration of analgesic therapy in the postoperative period with laparoscopic hernia repair is 2.4 days, and the duration of hospital stay after surgery is 3 days, much less than with traditional methods, in which the duration of analgesic therapy in the postoperative period is 3, 3 days, and the duration of hospital stay after surgery is 4.6 days. This analysis suggests that laparoscopic hernioplasty has an advantage over traditional methods.

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A COMPARITIVE STUDY OF ONLAY – SUBLAY MESHPLASTY (PHS) vs. LICHTENSTEIN MESHPLASTY OF INGUINAL HERNIA

10.36106/ijar/8602229 ◽

2021 ◽

pp. 56-58

Author(s):

Chenna Dharma Kishore Raja ◽

Sreerama Raja

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Return To Work ◽

Hospital Stay ◽

Mesh Repair ◽

Age Distribution ◽

P Value ◽

Tension Free ◽

Duration Of Surgery ◽

Type Of Surgery

Introduction: A Hernia is the protrusion of part of the abdominal contents beyond the abdominal wall's normal connes. In this study, an attempt is made to compare the results of two different modalities of hernia repair–Lichtenstein repair and repair of hernia with Polypropylene hernia system. Aim: The study aims to ascertain the Polypropylene hernia system's safety and benets for hernia repair against conventional Lichtenstein tension-free mesh repair technique. Materials and methods: The prospective clinical study comprises 30 patients presenting with inguinal hernia attending OPD and admitted to the General Surgery Department of King George Hospital, Visakhapatnam, during the study period of September 2018 to October 2020. Results: Age distribution between 10-90, most of the 50-70 age group (14 cases). Visual analog scale (VAS) score for PMR 4.55 ± 1.18 and LMR 6.06 1.27 (p-value <0.05). Wound infection for PMR 1 case and LMR 2 cases. Duration of surgery for PMR 65.40 ± 7.84 and LMR 51.33 ± 13.51 (p-value <0.05). Type of surgery and duration of hospital stay for PMR 4.93 ± 1.27 LMR 6.73 ± 2.12. Type of surgery and return to work for PMR 5.93 ± 1.27 and LMR 7.73 ± 2.12(p-value <0.05).Recurrence in PMR 0 % and LMR 6.67%. Conclusion: PHS repair is superior to Lichtenstein mesh repair about safe, tension-free method, shorter hospital Stay, early return to work, least recurrence rates, and a high subjective success rate and satisfaction rate.

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211879 ◽

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.

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

Journal of Enam Medical College ◽

10.3329/jemc.v10i1.45061 ◽

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

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P163 ROLE OF THE LAPAROSCOPIC APPROACH IN EMERGENT INGUINAL HERNIA REPAIR

British Journal of Surgery ◽

10.1093/bjs/znab395.152 ◽

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.

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Laparoscopic or open treatment for liver hydatid cyst? A single-institution experience: a prospective randomized control trial

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2417 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3088-3095

Author(s):

Saad Ab-razq Mijbas ◽

Samer Makki Mohamed Al-Hakkak ◽

Ali Abood Alnajim ◽

Hassan Abdulla Abadi AL-Aquli

Keyword(s):

Hydatid Cyst ◽

Hospital Stay ◽

Surgical Complication ◽

Randomized Study ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Laparoscopic Procedure ◽

Open Group ◽

P Value ◽

Liver Hydatid Cyst

The gold standard modality of management of cystic echinococcosis remains surgery. Regardless of the increased interest in nonsurgical techniques. The study aims to compare laparoscopic versus open methods of the hydatid cyst of the liver regarding complication rate, postoperative hospital stays, and effectiveness. A prospective randomized study. One hundred two patients with liver hydatid cyst in which 60 patients fulfil study requirements. Those undergone either open surgical or laparoscopic approaches under cover of albendazole treatment. The data divided into two groups, group 1 (28), group2 (32), we collected demographic data, surgical approach types, and postoperative data. The overall of 102 patients with hydatid cyst of the liver was randomized,60 patients full the study requirements, 28 patients (46.67%) had a laparoscopic procedure, and 32 patients (53.33%) had an open method. The total number of liver hydatid cysts was 70, and the operative time means 77 min (range,60–120 min) in the laparoscopic group and 55 min (range, 40–110 min) in the open group which is significant (P-value 0.0267). The postoperative hospital stay means time was 32 hours (range, 1–3 days) in the group of the laparoscopic procedure and 52 hours (range,2– 5days) in the group of open type. The postoperative surgical complication was significantly less in the laparoscopic group than the open group (p-value 0.014). A Hydatid liver cyst can be managed either by open surgical or laparoscopic techniques with comparable results. Still, the laparoscopic approach is superior in less postoperative pain, hospital stay and time, but it is essential in choosing the suitable patients.

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A COMPARATIVE STUDY ON OUTCOMES OF OPEN & LAPAROSCOPIC REPAIR IN INGUINAL HERNIA IN A TERTIARY CARE CENTRE

10.36106/ijsr/2500776 ◽

2020 ◽

pp. 23-25

Author(s):

Konkena Janardhana Rao ◽

K. Meghana ◽

N. Prahalada Reddy ◽

J. Ramanaiah ◽

Mamatha. V ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Comparative Study ◽

Hospital Stay ◽

Laparoscopic Hernia Repair ◽

Female Ratio ◽

Duration Of Surgery ◽

The Mean ◽

Operative Recovery ◽

Lichtenstein Operation

Background: Over the last decade, the field of hernia surgery got a new transformation, with exponential growth in mesh technology. Laparoscopic hernia repair has remained a contentious issue since its inception. Though a variety of procedures performed; none can be termed as an ideal procedure as each one is accompanied by varied early and late complications. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we have conducted a study in our institute, to compare Lichtenstein tension-free open hernioplasty with Transabdominal pre-peritoneal repair (TAPP) comparing the intraoperative and early postoperative complications. Methods: Our study was a single-centre, prospective comparative study conducted on sixty-one patients, over a period of 2 years from August 2018 to August 2020. All the cases included in the study were uncomplicated inguinal hernias. A detailed history of the symptoms, thorough clinical examination and investigations were done, which were analysed. Results: Most of the patients presented in the 5th decade. Male to female ratio of incidence of inguinal hernia was 11.2:1. Majority of the patients presented with unilateral hernia with right inguinal hernia being the most frequent presentation. The mean duration of surgery for TAPP is more when compared to Lichtenstein operation. The mean duration of hospital stay for open hernioplasty is more when compared to the laparoscopic hernia repair. TAPP is associated with lesser complications when compared to Lichtenstein's hernioplasty. Seroma, hematoma, and wound infection were the common complications noted. Conclusion: TAPP repair is a better procedure when compared to Lichtenstein operation in terms of hospital stay, post- operative recovery, intra-operative and post-operative complications.

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