Laparoscopic totally extraperitoneal repair versus open Lichtenstein hernioplasty in bilateral inguinal hernia: a comparative analysis
DOI:
https://doi.org/10.18203/2320-6012.ijrms20262818Keywords:
Bilateral inguinal hernia, Laparoscopic TEP repair, Lichtenstein hernioplasty, Postoperative pain, Minimally invasive surgery, Hernia recurrenceAbstract
Background: Bilateral inguinal hernia presents distinctive operative challenges. This study compared perioperative outcomes of open bilateral Lichtenstein hernioplasty and laparoscopic totally extraperitoneal (TEP) repair at a government tertiary care institution in Eastern India.
Methods: Historical patient records of 52 men with bilateral inguinal hernia were analysed. Group A (n=26) underwent open bilateral Lichtenstein hernioplasty; group B (n=26) underwent laparoscopic TEP repair. Primary outcome: visual analogue scale (VAS) pain score at 24 hours. Secondary outcomes: operative time, hospital stay, return to normal activity, complication rate, and hernia recurrence. Continuous variables are presented as mean±standard deviation (SD) and compared by independent t-test, reported with mean difference (MD) and 95% confidence intervals (CI). Categorical variables compared by Chi-square or Fisher exact test.
Results: Groups were comparable at baseline. VAS score was significantly lower in group B (3.3±0.9 versus 6.1±1.2; MD -2.8, 95% CI -3.4 to -2.2; p<0.001), exceeding the minimum clinically important difference of 1.5 points. Hospital stay was shorter (1.6±0.5 versus 3.2±0.7 days; MD -1.6, 95% CI -1.9 to -1.3; p<0.001) and return to activity was earlier (6.8±2.1versus 13.5±2.8 days; MD -6.7, 95% CI -8.1 to -5.4; p<0.001) in group B. Operative time was longer in group B (80±14 versus 64±11 min; MD +16, 95% CI 9.2-22.8; p<0.05). Complication rate (7.7% versus 23.1%; relative risk [RR] 0.33, 95% CI 0.07-1.50; p>0.05) and recurrence (0% versus 3.8%; p>0.05) did not differ significantly.
Conclusions: Laparoscopic TEP repair provides superior postoperative recovery over open bilateral Lichtenstein hernioplasty in terms of pain, hospital stay, and return to activity, without compromising safety or recurrence. It should be the preferred approach in appropriately selected patients at centres with trained laparoscopic surgeons.
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