Open versus Laparoscopic Mesh Repair of Inguinal Hernia

Abstract

Background - Inguinal hernia is the most common type of external abdominal hernia. Open Lichtenstein method or laparoscopic method can be employed to repair inguinal hernia. With the advent of laparoscopic mesh hernioplasty. Its superiority over open mesh hernioplasty is debatable. Method - This prospective study was done on 120 patients in the department of surgery of LLRM Medical College Meerut, to evaluate the usefulness of laparoscopic mesh hernioplasty (TEP Technique) for inguinal hernia repair versus conventional open mesh hernioplasty (Lichtenstein Technique) in terms of complications, pain and recurrence. Equal number of subjects was put in two groups; open mesh repair group and laparoscopic mesh repair group. Results -The mean age of the patients of inguinal hernia including both groups was 50 years. The mean operation time of Laparoscopic TEP mesh hernioplasty was 71.33 minutes while that of Open Lichtenstein repair was 36.33 minutes. Postoperative analgesic requirement was significantly lower in the patients operated by TEP technique as compared with patients treated by Open Lichtenstein’s technique.. In TEP group, two patients develops neuralgia, one patient developed fever, 1 patient developed hematoma, where as in the open group there were 3 cases of neuralgia , 3 cases had fever. Conclusion - Laparoscopic mesh hernioplasty using TEP technique is a novel technique with its share of advantages and disadvantages. There are potential benefits of laparoscopic repair for inguinal hernias in terms of post-operative pain, hospital stay and post operative complications. We recommend that a surgeon should use this laparoscopic technique for hernia repair after knowing all the pros and cons of the technique, his expertise for the technique and the infrastructure available.