Inguinal hernioplasty by laparoscopic total extraperitoneal versus open lichtenstein techniques : a randomized prospective study

Abstract EN

Background: Different techniques of laparoscopic inguinal hernioplasty are performed.

The total extraperitoneal approach (TEP) represents an important such technique.

In a randomized prospective study, we compared the TEP with the standard open repair, namely Lichtenstein hernioplasty.

Methodology: Thirty two adult males with inguinal hernia were included in the study.

They were randomly and equally divided into two groups; open Lichtenstein (OL) group and laparoscopic (TEP) group.

Data were collected regarding operative time, complications, postoperative pain, hospital stay, and resumption of normal activities.

The mean follow up period was 15 months ranging from 10 to 23 months.

Results: The OL group included two direct hernias, while the TEP group included three direct hernias while the rest were indirect.

The operative time for the OL group was significantly shorter than the TEP group with a mean and range of 44 (30-80) versus 95 (60-160) respectively.

TEP group had "" significantly less postoperative pain and analgesic needs compared to OL group.

TEP patients resumed their normal activities significantly sooner than OL patients.

Hospital stay did not differ between the two groups.

Intraoperative bleeding from the inferior epigastric artery occurred once in the TEP group and was well controlled.

Minor postoperative complications in the form of seroma, wound infection, and urinary retention were reported in both groups with no statistically significant differences and resolved spontaneously.

Conclusion: Although requires longer operative time than open Lichtenstein inguinal hernioplasty, laparoscopic TEP hernioplasty results in less postoperative pain, analgesic requirements, and earlier return to normal activities with comparable hospital stay and postoperative complications.

Consequently, laparoscopic TEP inguinal hernioplasty could be considered as a strong competitor to the standard Lichtenstein technique.

Still larger comparative studies with longer follow up are needed to objectively prefer one technique over the other.