Comparison of Early Complications and Recurrence rates between Laparoscopic (TAPP) and Open Repair (Lichtenstein) of Inguinal Hernia

Controversy exists over the preferred surgical method for inguinal hernia repair between the open and laparoscopic methods. This clinical trial was performed to compare the rate of early complications and recurrence rates of inguinal hernia between laparoscopic (TAPP) and open methods (Lichtenstein).

In this clinical trial, 84 patients who were candidates for elective inguinal hernia repair at Imam Hossain Hospital were randomly divided into two groups: TAPP and Lichtenstein groups. Spinal anesthesia was used for both groups. Patients were followed for short-term complications (e.g. infection, seroma, hematoma, postoperative pain), hospitalization stays, and recurrence within the first year. Data were analyzed using SPSS software (version 16).

There were no significant differences between the two groups in terms of age and gender. Unfortunately, in the TAPP group, 23 patients (54.8%) received general anesthesia due to lack of co-operation, excessive abdominal wall stiffness, and failure of spinal anesthesia. We found shorter hospitalization stay (P <0.001), less postoperative pain in the first 24 hours (P <0.001), and longer operative time (P <0.001) in the TAPP group compared with those in the Lichtenstein group. There were no significant differences between the two groups in terms of infection and recurrence rates in the first year. Seroma was seen only in 16.7% of the patients in the Lichtenstein group (P <0.012). Pain intensity measured in the first 24 hours at three-time points (1, 8, and 24 hours) was lower in the TAPP group with spinal anesthesia than in the TAPP with GA and Lichtenstein groups (P <0.001).

The results of this study showed that TAPP with spinal anesthesia is associated with reduced postoperative pain in the first 24h, and irrespective of the  type of anesthesia TAPP is associated with lower risk of seroma formation