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Comparative analysis of unilateral inguinal hernia repair using Lichtenstein and Prolene hernia system techniques in
Lorena Muniz1, Thiago Henrique Dos Santos1, Isabela Silva Dos Santos1
1Universidade de São Paulo - Faculdade de Medicina - Ribeirão Preto (SP) - Brazil.
Insights
The Prolene Hernia System (PHS) technique for inguinal hernia repair demonstrated shorter operative times and reduced hospitalization compared to the Lichtenstein method. Both surgical approaches for inguinal hernia repair proved safe and effective.
Area of Science:
- General Surgery
- Surgical Innovation
- Hernia Repair Techniques
Background:
- Inguinal hernias are common surgical conditions requiring effective repair.
- The Lichtenstein and Prolene Hernia System (PHS) are established techniques for inguinal hernia repair.
- Comparative outcome data for these techniques in public teaching hospitals are valuable.
Purpose of the Study:
- To compare early- and medium-term postoperative outcomes of unilateral inguinal hernia repair using Lichtenstein and PHS techniques.
- Evaluate operative time, complications, chronic pain, recurrence, and hospitalization rates.
Main Methods:
- Retrospective analysis of 897 patients undergoing primary unilateral inguinal hernioplasty.
- Comparison of Lichtenstein (406 patients) and PHS (491 patients) techniques.
- Statistical analysis using t-tests, Mann-Whitney, Fisher's exact, and χ2 tests.
Main Results:
- PHS technique associated with significantly shorter operative time (p < 0.01).
- Lower hospitalization rates observed with PHS (4.27% vs 12.8%, p < 0.01).
- No significant differences in postoperative complications, chronic pain, sensory dysfunction, or recurrence between groups.
Conclusions:
- Both Lichtenstein and PHS techniques are effective and safe for unilateral inguinal hernia repair.
- PHS technique offers advantages in operative time and hospitalization rates.
- Further prospective studies are needed due to sample size limitations and lack of cost-effectiveness data.
Purpose:
To compare early- and medium-term postoperative outcomes of unilateral inguinal hernia repair performed using the Lichtenstein and Prolene hernia system (PHS) techniques in a public teaching hospital.
Methods:
A retrospective analysis of 897 patients undergoing primary unilateral inguinal hernioplasty (406 with Lichtenstein and 491 with PHS) from January 2011 to March 2025 was conducted. Clinical, intraoperative, and postoperative data were collected and compared. Statistical analysis included t-tests, Mann-Whitney, Fisher's exact, and χ2 tests.
Results:
Groups were not entirely homogeneous in preoperative profiles. The mean age was similar (p = 0.85), with predominance of males (94.87%). The operative time was significantly shorter for the PHS group (68.83 ± 24.84 versus 76.23 ± 26.90 min; p < 0.01). No significant differences were observed in postoperative complications, chronic pain, sensory dysfunction, or recurrence. Hospitalization was less frequent with the PHS technique (4.27 versus 12.8%; p < 0.01). Greater preference for local anesthesia was observed in the PHS group (20.77 versus 4.68%; p < 0.01).
Conclusion:
Both techniques proved effective and safe, but the PHS technique showed advantages regarding operative time and hospitalization rate. However, limited sample size and absence of cost and return-to-activity data restrict broader generalizations. Further prospective randomized studies are needed.
