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Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair.

A Eklund¹, C Rudberg, C-E Leijonmarck

¹Department of Surgery, Västerås Hospital, 721 89, Västerås, Sweden. arne.eklund@ltv.se

Surgical Endoscopy

|March 17, 2007

Summary

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For recurrent inguinal hernia repair, laparoscopic transabdominal preperitoneal patch (TAPP) offers less pain and shorter sick leave. Long-term recurrence rates are similar to the Lichtenstein technique.

Area of Science:

General Surgery
Minimally Invasive Surgery

Background:

Recurrent inguinal hernias present a significant clinical challenge due to high re-recurrence rates.
Optimal surgical strategies for recurrent inguinal hernia repair remain a subject of ongoing investigation.

Purpose of the Study:

To compare the short- and long-term outcomes of laparoscopic transabdominal preperitoneal patch (TAPP) versus the Lichtenstein technique for recurrent inguinal hernia repair.

Main Methods:

A randomized multicenter study involving 147 patients (73 TAPP, 74 Lichtenstein).
Comparison of operative time, postoperative pain, sick leave duration, and recurrence rates at 5 years.

Main Results:

Operating times were comparable between TAPP (65 min) and Lichtenstein (64 min) groups.

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TAPP group experienced significantly less postoperative pain and shorter sick leave (8 days vs. 16 days).

Five-year recurrence rates were similar: 19% for TAPP and 18% for Lichtenstein.

Conclusions:

Laparoscopic TAPP provides short-term benefits including reduced pain and faster return to work.
No significant differences in long-term chronic pain or recurrence rates were observed between TAPP and Lichtenstein techniques.