Comparison between Laparoscopic Transabdominal Preperitoneal Approach and Lichtenstein Repair for Unilateral Inguinal Hernia: A Prospective Interventional Study
Introduction: Open and laparoscopic surgical methods are widely used for the treatment of inguinal hernias. Laparoscopic Transabdominal Preperitoneal (TAPP) repair is a minimally invasive approach and is one of the preferred methods for younger surgeons to treat inguinal hernias. Aim: To compare th...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/20902/78026_CE[Ra1]_F(SHU)_QC(PS_OM)_PF1(AG_OM)_PFA_NC(IS)_PN(IS).pdf |
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| Summary: | Introduction: Open and laparoscopic surgical methods are widely used for the treatment of inguinal hernias. Laparoscopic Transabdominal Preperitoneal (TAPP) repair is a minimally invasive approach and is one of the preferred methods for younger surgeons to treat inguinal hernias.
Aim: To compare the intraoperative and postoperative complications, chronic pain, length of hospital stay and return to normal work associated with laparoscopic TAPP surgery and Lichtenstein open mesh repair for unilateral inguinal hernia in males.
Materials and Methods: This prospective interventional study was conducted from January 2022 to December 2022 on 60 clinically diagnosed cases of primary unilateral direct and indirect inguinal hernias in the Department of Surgery, Uttar Pradesh University of Medical Sciences (UPUMS), Saifai, Etawah, Uttar Pradesh, India. Based on inclusion and exclusion criteria during, a total of 60 patients were included in the study and divided into two groups of 30 patients each using a random number table. In group A, patients underwent laparoscopic TAPP surgery, while in group B, Lichtenstein hernioplasty (open surgery) was performed. Patients were evaluated for intraoperative complications and postoperative pain using the Visual Analog Scale (VAS) for three consecutive days. They were followed-up one week postoperatively to monitor for common complications in both groups. Additionally, patients were followed-up at one month, three months and six months postoperatively for clinical recurrence of hernia and reports of pain in either group. The Chi-square test was used for comparison of categorical variables between the two groups and the Student’s t-test was used for continuous variables.
Results: The overall mean age of the patients was 46.57±17.13 years, while the median age was 50 years. Vascular injury was present in one patient (2.33%) in group A (TAPP group). Intraoperative complications in group A and group B were statistically non significant for vas deferens injury, vascular injury, bladder injury and visceral injury. Postoperative complications during the first week of the postoperative period included stitch abscess and abdominal distension, which were statistically non significant. Seroma formation (c2=0.87, p-value=0.35), scrotal swelling (c2=0.27, p-value=0.61) and urinary symptoms (c2=0.00, p-value=1.00) were also non significant (p-value >0.05). Pain at one month, three months and six months follow-ups was not observed in group A, while in group B, pain was present in two patients (6.67%) at one month, one patient (3.33%) at three months and one patient (3.33%) at six months. Pain was statistically non significant in both groups. Recurrence of hernia at one month, three months and six months postoperatively was not observed in either group A or group B. The mean length of hospital stay in the TAPP group was 3±0.46 days, while in the Lichtenstein group it was 4±0.87 days. The mean time to return to normal work in the TAPP group was 6.6±1.22 days, while in the Lichtenstein group, the mean time was 14±3.37 days.
Conclusion: In unilateral inguinal hernia, laparoscopic TAPP repair is safer and comparable to Lichtenstein repair in terms of complications. In the TAPP group, pain, length of hospital stay and time to return to normal work were lower compared to the Lichtenstein repair. In both groups, no hernia recurrence was observed at the six-month follow-up. |
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| ISSN: | 2249-782X 0973-709X |