Comparison of the Lichtenstein technique and transabdominal pre-peritoneal hernia repair in geriatric patients

This study aimed to compare the Lichtenstein technique and the transabdominal pre-peritoneal (TAPP) approach regarding safety and patient comfort in geriatric patients with inguinal hernia, and to evaluate the safety of laparoscopic surgery in this population.

This prospective study included patients aged ≥65 years who were hospitalised with an inguinal hernia and underwent surgical repair. Pre-operative complete blood count and biochemical parameters, operation and anaesthesia durations, and length of hospital stay were recorded through retrospective chart review. Post-operative patient satisfaction was assessed using the ODOMS questionnaire during outpatient follow-up. Patients were divided into two groups according to surgical technique: Lichtenstein repair and TAPP procedure.

A total of 125 patients developed complications. Among these, 110 cases (25.3%) occurred in the Lichtenstein group and 15 cases (3.4%) in the TAPP group, indicating a significantly lower complication rate with the laparoscopic approach ( P < 0.001). There were no statistically significant differences between groups in terms of ASA scores, anaesthesia duration or operative time ( P = 0.196 and P = 0.082, P = 0.147). However, the length of hospital stay was significantly shorter in the TAPP group ( P = 0.014). In addition, patient satisfaction scores measured by the ODOMS questionnaire were significantly higher in the TAPP group ( P = 0.003).

Laparoscopic TAPP repair appears to be a safe and effective alternative to open Lichtenstein repair in geriatric patients. It is associated with fewer complications, shorter hospitalisation, and higher patient satisfaction, without increasing operative or anaesthesia duration.