A Comparative Study of Laparoscopic (TEP) and Open Inguinal Hernia Repair (Lichtenstein Method): A Prospective Analytical Study

Background: Laparoscopic inguinal hernia repair has emerged as a viable alternative to the open procedure. However, laparoscopic hernioplasty by totally extraperitoneal repair (TEP) technically eliminates the hazards of intra operational injuries. The present study was undertaken to compare the effectiveness of laparoscopic repair (TEP) Vs open (Lichtenstein Method) repair of inguinal hernia.

Methods: This prospective analytical study was conducted in the Department of General Surgery in a tertiary referral hospital during a period of 30 months from June 2018 to November 2020 comprising of total 150 patients with unilateral or bilateral inguinal hernia in two groups : laparoscopic TEP group (study group) and open mesh repair group (control group).

Results: Operative time for laparoscopic TEP hernioplasty was more (82.13 min) as compared to open repair (65.6min). In bilateral hernia cases, TEP had significantly lower operative time than open repair while in unilateral hernia cases open repair had lower operative time. The frequency of postoperative chronic pain was found to be more with laparoscopic TEP hernioplasty (12%) as compared to open (6.67%). Postoperative complication rate was 34.66% in the study group and 45.33% in the control group. Recovery was faster with laparoscopic repair with a mean postoperative hospital stay of 2.41days compared to 3.61days for open mesh repair. Only one recurrence was noted among TEP repair.

Conclusion: Laparoscopic TEP hernioplasty offers a significant advantage over open Lichtenstein hernioplasty like early recovery, reduced hospital stay, lesser analgesic dose requirement, early resumption of normal activity and better quality of life in consideration with bodily pain.