A prospective comparative study of outcome between open lichtenstein versus laparoscopic repair of inguinal hernia

Sushila Choudhary; Hitesh Soni; Jagdish M. Mehta; Saurabh Kalia

doi:10.18203/2320-6012.ijrms20211879

Authors

Sushila Choudhary Department of General Surgery, Narayana Multispeciality Hospital, Jaipur, Rajasthan, India
Hitesh Soni Department of General Surgery, Narayana Multispeciality Hospital, Jaipur, Rajasthan, India
Jagdish M. Mehta Department of General Surgery, Narayana Multispeciality Hospital, Jaipur, Rajasthan, India
Saurabh Kalia Department of General Surgery, Narayana Multispeciality Hospital, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20211879

Keywords:

Inguinal hernia, Laparoscopic, Open, Technique

Abstract

Background: Laparoscopic hernia repair is technically difficult and has long learning curve than open repair. Moreover, with increased cost of procedure do patient really get benefited in terms of intraoperative time duration, post-operative pain and complications, length of hospital stays, and time taken to return to usual activity needs to be studied.

Methods: In this prospective observational study of 100 patients including unilateral, bilateral, direct and indirect inguinal hernia and excluding obstructed and strangulated hernia, 61 patients underwent open repair and 39 patients underwent laparoscopic hernia repair. Pain analysis was done with visual analogue scale. Unpaired student T test and Chi square test used (p<0.05).

Results: Baseline characteristics age, sex of the two groups were similar. Mean operative time in laparoscopic group was 105.38±35.13 minutes and in open group was 79.95±31.12 minutes (p<0.001). There was statistically significant difference in mean pain score of laproscopic verses open techniques (p<0.001). Urinary retention was the most common post-operative complication in both groups but was statistically not significant. Mean hospital stay in laparoscopic group was 1.56±0.50 days and in open group was 1.9±0.50 days (p-0.002). Mean time taken to return to usual activity in open repair was 41.10±27.15 days and in laparoscopic group was 16.23±6.37 days (p-0.001).

Conclusions: This study showed that in laparoscopic repair of inguinal hernia patients have less post-operative pain, shorter hospital stays and early return to work. However, the laparoscopic technique had longer operative time duration.

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Author Biography

Sushila Choudhary, Department of General Surgery, Narayana Multispeciality Hospital, Jaipur, Rajasthan, India

Senior Manager,

Academic and Research Department

Narayana Multispeciality Hospital,Jaipur

References

Fischer JE, William V. Fischer mastery of surgery. 7th Edition. South Asian, Wolters Kluwer. 2018:2211.

Pachade V. Inguinal hernioplasty open or laparoscopic. Int J Res. 2016;2(5):4.

Johanson BO, Hallerback B, Hans G. Laparoscopic mesh verses conventional tech for inguinal hernia repair. Annals Surg. 1999;3:55-9.

Eklund AC, Rudberg S, Smedberg LK. Enander CE. Short term results of a randomised clinical trial comparing lichtenstein open repair with total extraperitoneal laparoscopic inguinal hernia repair. British J Surg. 2006;93:1060-8.

Mohamad Z, Ziaul I, Syed SH. Open lichtenstein repair verses laparoscopic transabdominal preperitoneal repair for inguinal hernia. J Surg. 2014;19(2):55-60.

Hamza Y. Four-arm randomized trial comparing laparoscopic and open hernia repairs. Int J Surg. 2009;8(1):25-8.

Tolba M, Khairi A, Eldin O. Tension-free mesh inguinal hernia repair laparoscopic or open? J Mini Inv Surg Sci. 2012;1:149-53.

Galati EH, Gundlure R, Gousia B. A comparative study of laparoscopic TEP and open Lichtenstein tension free hernia repair a single surgical unit experience. Evaluation Med Dent Sci. 2016;5(80);5956-9.

Garg P, Agumbe S, Vijaykumar H. Comparision of early postoperative outcome of laparoscopic and open inguinal hernia mesh repair. Int Surg J. 2018;5(8):2732-6.

Murty PK, Ravalia D. Assesment and comparision of laparoscopic hernia repair verses open hernia anon-randomized study. Int Surg J. 2018;5(3):1021-5.

Sudarshan PB, Sundaravadanan BS, Kaarthik VP, Shankar P. A comparative study of laparoscopic verses open repair of inguinal hernia. Int surg J. 2017;4(3):921-5.

Cormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E. Laparoscopic surgery for inguinal hernia repair: review of effectiveness and economic evaluation. Health Technol Assess. 2005;9(14):1-203.

Memon B, Memon MI, Abrams KR. Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg. 2003;90(12):149-92.

Wellwood J, Sculpher MJ, David S. Randomised control trial of laparoscopic verses open mesh repair of inguinal hernia outcome and cost. BMJ. 1998;11:7.

Ansari M, Srivastava V, Acharya N, Acharya R. Comparision of outcomes (early and late) following open and laparoscopic repair of inguinal; an experience of a single surgical unit. Impect J. 2014;2(2):163-8.

Collaboration LH, laparoscopic compared with open method of groin hernia repair; systemic review of randomised controlled trail. Br J Surg. 2000;87;860.

Tolba M, Khairi A, Eldin O. Tension-free mesh inguinal hernia repair laparoscopic or open? J Mini Inv Surg Sci. 2012;1:149-54.

Simons J. European hernia society guidelines on the treatment of inguinal hernia in adult patients. 2009;13(4);343-63.

Felix E, Harbertson N, Vartanian S. Laparoscopic hernioplasty. Surg Endosce. 1999;13:328-31.

Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endose. 2005;19:188-99.

Wall ML, Cherian T, Lotz JC, Laparoscopic hernia repair the best option? Acta Chir Belg. 2008;108(2):186-91.

22. Bittner R, Schmedt CG Schwarz J, Kraft K, Leibl BJ. Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg. 2002;89(8):1062.

Kozol R, Lange PM, Kosir M, Beleski k, Mason K, Tennenberg S, et al. A prospective, randomized study of open vs laparoscopic inguinal hernia repair. An assessment of postoperative pain. Arch Surg. 1997;132(3):292-5.

Cormack K, Scott NW, Go PM, Ross S, Grant AM. Hernia trialists collaboration laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;1:CD001785.

Yasar ED, David C, Emmett C, Deakin M. Laparoscopic verses open inguinal hernia a longitudinal cohort study. Surg Endo. 2013;27:936-45.

Simons MP, Aufenacker ET, Nielsen BM. European hernia society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13:343-403.

Treadwell J, Tipton K, Oyesanmi. Surgical options for inguinal hernia: comparative effectiveness. Surg Endo. 2018;6:85.

Mccormack K. Laparoscopic technique verses open technique for inguinal hernia repair. Cochrane Database Syst Rev. 2003;1:62-9.

McNally MP, Byrd KA, Duncan JE, Shepps CD. Laparoscopic versus open inguinal hernia repair: expeditionary medical facility Kumwait experience. Military Med. 2009;174(12):1320-3.

Mahesh GS. Laparoscopic versus open mesh repair for inguinal hernial. Indian J Res. 2015;11:104-6.