Related Experiment Video
Updated: Jun 19, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Four-arm randomized trial comparing laparoscopic and open hernia repairs
Yasser Hamza1, Esam Gabr, Habashi Hammadi
1Department of Surgery, Faculty of Medicine, University of Alexandria, Azarita, Alexandria 21162, Egypt. hamzay3@hotmail.com
Aim:
To compare four approaches in primary repair of inguinal hernia as regards operative and postoperative outcome.
Methods:
One hundred consecutive patients with primary inguinal hernia Nyhus I-III were randomized into four groups. Group I had open pro-peritoneal repair, group II had Lichtenstein tension-free mesh repair, group III had Transabdominal pro-peritoneal (TAPP) repair while group IV had laparoscopic totally extraperitoneal (TEP) hernia repair.
Results:
Operative time ranged from 10.71 to 120.61 min. Laparoscopic operations were significantly longer than open operations (54.5+13.2, 34.21+23.5 versus 96.12+22.5, 77.4+43.21; t=3.891, p<0.001). Open pro-peritoneal approach had significantly longer operative time compared to Lichtenstein approach (54.5+13.2 versus 34.21+23.5). Postoperative pain was significantly higher in patients who had open repairs (7.067+1.831, 6.5+3.5 versus 5.8+1.568, 4.8+2.33; t=3.424, p=0.002). There was one case of conversion in each of the two laparoscopic groups. Laparoscopic operations were associated with significantly faster return to normal domestic activities and to work.
Conclusion:
Laparoscopic hernia repair offers less postoperative pain and faster recovery on the expense of longer operative time. TEP and TAPP laparoscopic techniques gave similar results.
