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Transabdominal Preperitoneal Repair Versus Lichtenstein's Open Hernia Repair for Inguinal Hernias: A Retrospective
Supriya Bhondve1, Kashif F Ansari1, Rajalakshmi Venkateswaran1
1General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND.
Introduction:
Inguinal hernia repair is one of India's most common procedures in general surgery. The advent of minimally invasive surgery for this condition has revolutionized its treatment. This study compares the outcomes of transabdominal preperitoneal (TAPP) repair and Lichtenstein's open hernia repair, focusing on specific intraoperative and perioperative outcomes.
Materials And Methods:
A retrospective analysis was conducted on patients who underwent either TAPP repair or open hernia repair at a single tertiary care center between June 2021 and June 2024. A total of 120 patients were included, with Group A comprising 60 patients who underwent TAPP repair and Group B comprising 60 patients who underwent open hernia repair. In addition to demographic data, parameters such as operative time, length of hospital stay, postoperative pain score using the Visual Analogue Scale (VAS), and incidence of postoperative complications were analyzed. Statistical comparisons were made using chi-square and t-tests, with a significance level set at p < 0.05.
Results:
The mean operative time for Group A and Group B was 137.43 ± 24.41 minutes and 108.91 ± 36.73 minutes, respectively, which was statistically significant (p < 0.001). Although individual complications varied, the complications were 11.66% (seven patients) in Group A and 38.33% (23 patients) in Group B. The VAS revealed that the average pain score at 24-48 hours was 4.05 ± 0.80 in Group A and 4.3 ± 0.74 in Group B, indicating a statistically significant lower pain level in Group A (p = 0.03). At the end of one week, the average pain score was significantly lower in Group A (1.18 ± 0.42 vs. 1.55 ± 0.67, p < 0.001). The average duration of hospital stay was 2.3 ± 0.64 days for Group A and 3.01 ± 0.911 days for Group B. An unpaired t-test showed statistically significant differences between the two groups' hospital stay duration and time taken to return to normal work (t = 4.98, p < 0.001 and t = 14.041, p < 0.001, respectively). The average number of days for which analgesics were required was 1.1 in Group A and 1.6 in Group B.
Conclusions:
TAPP repair offers significant advantages in terms of postoperative pain and recovery time compared to traditional open hernia repair. Although TAPP repair requires a longer operative time, its benefits, such as reduced recovery duration and lower postoperative pain, could lead to better patient outcomes and reduced strain on healthcare resources. Both techniques showed comparable complications and hernia recurrence rates, suggesting that TAPP repair is a safe and effective alternative to open hernia repair. Future studies with larger sample sizes and longer follow-up periods are recommended to further assess the long-term efficacy and cost-effectiveness of TAPP repair compared to open hernia repair.
