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

Abstract

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.