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

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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Comparative study of laparoscopic hernia repair versus open hernia repair

Journal of Nobel Medical College ◽

10.3126/jonmc.v7i2.22303 ◽

2018 ◽

Vol 7 (2) ◽

pp. 30-34

Author(s):

Rohit Prasad Yadav ◽

Dipendra Thakur ◽

Bashu Dev Baskota ◽

Amit Kumar Shah ◽

Kaushal Samsher Thapa ◽

...

Keyword(s):

Hernia Repair ◽

Comparative Study ◽

Hospital Stay ◽

Laparoscopic Hernia Repair ◽

Fatty Tissue ◽

Duration Of Surgery ◽

Group 2 ◽

Lower Pain Score ◽

Open Hernia Repair ◽

Group 1

Background: Hernia is the abnormal exit of an organ or fatty tissue, such as the bowel, through the weak wall of the cavity in which it normally resides. Repair of inguinal hernia is common surgical procedures. This study aims to compare between laparoscopic and open hernia repair. Method: Study is non randomized comparative study. Study includes 76 patients who had undergone surgery for hernioplasty. Among them 38 undergone laparoscopic hernioplasty and 38 undergone open hernioplasty from June 2016 to August 2018. Results: Mean hospital stay was 2.95 days in group 1 and 4.03 in group 2 .VAS was found to be 2.45 in group 1 and 5.71 in group 2 which is significantly low in group 1 patients with p<0.001. Duration of surgery is more in group 1 with mean duration of 94.08 minutes comparing to group 2 with mean duration of 43.55 minutes (with p<0.001). Conclusion: Laparoscopic hernia repair offers advantages over open repair in terms of less hospital stay and lower pain score for patient not contraindicated for general anesthesia and complicated hernia.

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Desarda’s versus Lichtenstein technique of inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20175553 ◽

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.

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A comparative study between open lichtenstein mesh repair and laparoscopic totally extra peritoneal repair of inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20181419 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1733

Author(s):

Karthik Pooraneson ◽

Chandrashekar N. ◽

Ved Prakash Ranjan ◽

Yamuna V. S.

Keyword(s):

Inguinal Hernia ◽

Comparative Study ◽

Hospital Stay ◽

Mesh Repair ◽

Tep Repair ◽

Duration Of Hospital Stay ◽

Post Operative Pain ◽

The Mean ◽

Operative Recovery ◽

Study Participants

Background: The study was conducted to compare and assess the duration of procedure, complications encountered, post-operative pain and recovery, duration of hospital stay, and time taken in resumption to work between two techniques of open Lichtenstein mesh repair (OLMR) and Totally extra peritoneal (TEP) repair in the low resource settings.Methods: A cross sectional comparative study was conducted among 50 male patients admitted for surgical repair of hernia. After considering the inclusion and exclusion criteria, the subjects were randomly assigned to the groups of OLMR and TEP and were assessed for pain in the post-operative period was rated using a Visual Analogue Scale. Total duration of the procedure, complications, duration of hospital stay, and time taken in resumption to work were elicited between two techniques. A p-value of <0.05 was taken as statistically significant.Results: The mean duration of surgery among the study participants in TEP (49.60+3.62 mins) group was significantly higher compared to OLMR (45.96+4.63 mins) group (p=0.003). The median of post-operative pain scores in TEP group was significantly lower compared to OLMR group. The mean duration of post-operative recovery time (3.08+0.4 days), for resumption to work (5.08+0.28 days) among the study participants in TEP group was significantly lower compared to OLMR (5.00+0.00 days), (10.08+0.76 days) (p<0.001) respectively. The complications were significantly higher among the OLMR group (100.0%) compared to the TEP group (p<0.05).Conclusions: Though the procedure of TEP repair for inguinal hernia takes a little longer time and complications of general anaesthesia cannot be ruled out, it is a better procedure compared to open type.

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A comparative study between open and laparoscopic repair of inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20193681 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3353

Author(s):

Mahim Koshariya ◽

Mayank Soni ◽

Prateek Malpani ◽

Bhupendra Parmar ◽

Shikha Shukla

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Comparative Study ◽

Hospital Stay ◽

Laparoscopic Repair ◽

Operative Time ◽

Laparoscopic Hernia Repair ◽

Repair Group ◽

Open Hernia Repair

Background: Hernias of the abdominal wall constitute an important public health problem. Laparoscopic inguinal hernia repair (TEP) is a minimal access surgical procedure as compared to open hernia repair. The objective of the study was to compare open and laparoscopic hernia repair in terms of safety, complications, morbidity, recurrence, post-op pain and hospital stay.Methods: This was a prospective observational comparative study. Total 50 patients were taken in this study; out of them 25 patients subjected to group A (open repair of inguinal hernia) and 25 patients subjected to group B (laparoscopic repair of inguinal hernia). Postoperatively patients were observed for any complications and followed up one year.Results: Present study shows high incidence of inguinal hernia in males. Mean operative time for open hernia repair group was less than laparoscopic hernia repair group. Time to return to normal work, duration of hospital stay and postoperative pain were less in laparoscopic hernia repair group than open hernia repair group. Out of 25 patients in laparoscopic hernia repair (TEP) 1 patient had recurrence but in open hernia repair group there was no recurrence.Conclusions: Laparoscopic hernia repair is quite safe; it has definite advantages in bilateral and recurrent cases, postoperative pain, early return to normal activities, less postoperative hospital stay and better cosmetic results although it has its own disadvantages in terms of recurrence rate, operative time and cost effectiveness.

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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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Comparative Study between the Use of Self-Fixating Mesh and Non Self-Fixating Mesh in Laprascopic Inguinal Hernia Repair Transabdominal Preperitoneal (TAPP) Technique

QJM ◽

10.1093/qjmed/hcaa042.008 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

E F Ebied ◽

A A Khalil ◽

A I I Soliman

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Comparative Study ◽

Inguinal Hernia Repair ◽

Inguinal Hernioplasty ◽

Vas Score ◽

Group A ◽

The Mean ◽

Group B

Abstract Background Hernia is a common problem of the modern world with an incidence ranging from 5%-7%. Of all groin hernias, around 75% are inguinal hernias. Recently with advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work. Aim of the Work To compare between self fixating mesh and non self fixating mesh in laproscopic inguinal hernia repair transabdominal preperitoneal (TAPP) approach as regards intraoperative time, complications, postoperative pain, return to normal activity and incidence of recurrence. Patients and Methods This study was conducted on 30 adult patients presenting with inguinal hernias. They were divided into 2 equal groups of 15 patients each. The first group (A): includes fifteen patients and was operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique using self -gripping (SGM group) (Parietex ProGrip] Laparoscopic (PPL) meshes), while the second group (B): includes fifteen patients and were operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique with non-self fixating mesh. Results The postoperative pain assessment at 24 hours and 4 weeks shows that the mean VAS score for GROUP A was (3.70 ± 1.72) and for GROUP B (3.90 ± 1.25) while after 1 month duration follow up, the mean VAS score was (1.25 ± 0.79) for Group A and (1.20 ± 0.77) for Group B with no difference between the two groups confirming the atraumatic nature of the self gripping mesh. Conclusion After this comparative study, both mesh fixation with absorpable tacks and fixation using SGM approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature.

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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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Inguinal hernia repair – TEP or TAPP?? A comparative analysis between both the laparoscopic procedures in a tertiary care center

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i6.30776 ◽

2020 ◽

Vol 11 (6) ◽

pp. 84-88

Author(s):

Atia Zaka Ur Rab ◽

Sheikh Saif Alim ◽

Wasif Mohammad Ali ◽

Syed Amjad Ali Rizvi

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Prospective Study ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Tertiary Care ◽

Number Of Patients ◽

Significant Difference ◽

Duration Of Surgery ◽

Normal Work

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.

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Desarda repair no Mesh and Lichtenstein repair for inguinal hernia (A study of 2793 patients)

Clinical Medical Reviews and Reports ◽

10.31579/2690-8794/096 ◽

2021 ◽

Vol 3 (9) ◽

pp. 01-05

Author(s):

Pedro Rolando Lòpez Rodrìguez ◽

Eduardo Garcia Castillo ◽

Olga Caridad Leòn Gonzàlez ◽

Jorge Agustin Satorre Rocha ◽

Luis Marrero Quiala ◽

...

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Controlled Trial ◽

Operation Time ◽

Lichtenstein Repair ◽

Prospective Randomized Controlled Trial ◽

Duration Of Surgery ◽

The Mean ◽

Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair.

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