A Comparison of outcome between Transabdominal Preperitoneal (TAPP) and Lichtenstein operation for primary inguinal hernia repair – An institutional study
Running title – A Comparison of outcome between Transabdominal Preperitoneal (TAPP) and Lichtenstein operation
Abstract
Introduction: Inguinal hernia repairs are one of the most common operations in general surgery. Apart from the classical open repairs, minimally invasive approaches are increasingly preferred to manage groin hernia repair. However, the optimal surgical approach still remains controversial.Methods: This is a prospective observational study done in Shree Birendra Hospital, a 750- bedded tertiary care military hospital located in Kathmandu from July 2021 to December 2021. A total of 120 patients operated for inguinal hernia by either open Lichtenstein repair or Transabdominal Preperitoneal (TAPP) in the department of surgery were included in this study.
Results: The mean age of patients between open Lichtenstein repair and TAPP was 59.3 (22-79) and 63.4 (27-70) years respectively. The majority of patients were male among both the groups constituting of more than 95%. The mean intraoperative duration among the two groups was 44.12±7.23 minutes and 77.43±8.77minutes, respectively (p=0.021). The mean postoperative pain was less in TAPP procedure compared to open procedure (p=0.037). The mean duration of the postoperative hospital stay was 2± 1.12 and 1±0.79 respectively. At the three-month evaluation, there were four cases of recurrence of which one of them underwent open procedure while three underwent TAPP procedure.
Conclusion: Both the open Lichtenstein repair and the TAPP procedures are safe and effective in the repair of primary inguinal hernia. In a view of postoperative pain, seroma formation and length of hospital stay TAPP procedure has been found superior to open procedure in our study.
References
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23. Kargar S, Shiryazdi SM, Zare M, Mirshamsi MH, Ahmadi S, Neamatzadeh H. Comparison of postoperative short-term complications after laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein tension free inguinal hernia repair: a randomized trial study. Minerva Chir. 2014;70(2):83–9. [PubMed Full text DOI]
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26. Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc. 2003;17(6):850.
[PubMed Full text DOI]
27. Ghani A, Khalil J, Khan MI, Khan H. Laparoscopic transabdominal preperitoneal versus lichtenstein tension free repair for inguinal hernia. Pak J Surg. 2012;28(1):6– 11. [ Full text DOI]
2. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR. Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 2003; 90: 1479–1492. [PubMed Full text DOI]
3. Sultan B, Qureshi Z, Malik MA. Frequency of external hernias in Ayub Teaching Hospital Abbotabad. J Ayub Med Coll Abbotabad 2009; 21(3): 57–58. [PubMed Full text DOI]
4. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989;157(2):188–93.
[PubMed Full text DOI]
5. Leibl BJ, Jäger C, Kraft B, Kraft K, Schwarz J, Ulrich M, et al. Laparoscopic hernia repair—TAPP or/and TEP? Langenbecks Arch Surg. 2005;390(2):77–82.
[PubMed Full text DOI]
6. Scott NW, McCormack K, Graham GP, Go PM, Ross S, Grant AM. Open mesh versus non-mesh for groin hernia repair. Cochrane Database of Systematic Reviews. 2002;(4). [PubMed Full text DOI]
7. Bringman S, Ramel S, Heikkinen T-J, Englund T, Westman B, Anderberg B. Tension-free inguinal hernia repair: TEP versus mesh-plug versus Lichtenstein: a prospective randomized controlled trial. Ann Surg. 2003;237(1):142.
[PubMed Full text DOI]
8. Johansson B, Hallerbäck B, Glise H, Anesten B, Smedberg S, Román J. Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg. 1999;230(2):225.
[PubMed Full text DOI]
9. Gong K, Zhang N, Lu Y, Zhu B, Zhang Z, Du D, et al. Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally
extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc. 2011;25(1):234–39. [PubMed Full text DOI]
10. Hamza Y, Gabr E, Hammadi H, Khalil R. Four-arm randomized trial comparing laparoscopic and open hernia repairs. Int J Surg. 2010;8(1):25–28. [PubMed Full text DOI]
11. Schneider BE, Castillo JM, Villegas L, Scott DJ, Jones DB. Laparoscopic totally extraperitoneal versus Lichtenstein herniorrhaphy: cost comparison at teaching hospitals. Surg Laparosc Endosc Percutan Tech 2003; 13: 261–267. [PubMed Full text DOI]
12. Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK. Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. Br J Surg 2010; 97(1): 4–11. [PubMed Full text DOI]
13. Eklund A, Montgomery A, Bergkvist L, Rudberg C. Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy (SMIL) study group. Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 2010; 97(4): 600–608. [PubMed Full text DOI]
14. Wright D, Caron Paterson NS, Hair A, O’Dwyer PJ. Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg. 2002;235(3):333. [PubMed Full text DOI]
15. Heikkinen T, Bringman S, Ohtonen P, Kunelius P, Haukipuro K, Hulkko A. Five- year outcome of laparoscopic and Lichtenstein hernioplasties. Surg Endosc Interv Tech. 2004;18(3):518–22.
[PubMed Full text DOI]
16. Desarda MP. Surgical physiology of inguinal hernia repair-a study of 200 cases. BMC Surg. 2003;3(1):1–7.
[PubMed Full text DOI]
17. Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc Interv Tech. 2004;18(2):221–7.
[PubMed Full text DOI]
18. Fitzgibbons RJ, Forse RA. Clinical practice. Groin hernias in adults. N Engl J Med. 2015 Feb 19;372(8):756–63. [PubMed Full text DOI]
19. Pokorny H, Klingler A, Schmid T, Fortelny R, Hollinsky C, Kawji R, et al. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia. 2008;12(4):385–9. [PubMed Full text DOI]
20. Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia J Hernias Abdom Wall Surg. 2015 Jun;19(3):355–66. [PubMed Full text DOI]
21. Salma U, Ahmed I, Ishtiaq S. A comparison of postoperative pain and hospital stay between Lichtenstein’s repair and Laparoscopic Transabdominal Preperitoneal (TAPP) repair of inguinal hernia: A randomized controlled trial. Pak J Med Sci. 2015;31(5):1062. [PubMed Full text DOI]
22. Aly O, Green A, Joy M, Wong CH, Al-Kandari A, Cheng S, et al. Is laparoscopic inguinal hernia repair more effective than open repair. J Coll Physicians Surg Pak. 2011;21(5):291–6. [PubMed Full text DOI]
23. Kargar S, Shiryazdi SM, Zare M, Mirshamsi MH, Ahmadi S, Neamatzadeh H. Comparison of postoperative short-term complications after laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein tension free inguinal hernia repair: a randomized trial study. Minerva Chir. 2014;70(2):83–9. [PubMed Full text DOI]
24. Arregui ME, Young SB. Groin hernia repair by laparoscopic techniques: current status and controversies. World J Surg. 2005;29(8):1052–7. [PubMed Full text DOI]
25. Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B, Gockel I. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair–A systematic review and meta-analysis of randomized controlled trials. BMC Surg. 2017;17(1):55. [PubMed Full text DOI]
26. Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc. 2003;17(6):850.
[PubMed Full text DOI]
27. Ghani A, Khalil J, Khan MI, Khan H. Laparoscopic transabdominal preperitoneal versus lichtenstein tension free repair for inguinal hernia. Pak J Surg. 2012;28(1):6– 11. [ Full text DOI]
Published
2022-08-17
How to Cite
RAYAMAJHI, Bikash Bahadur et al.
A Comparison of outcome between Transabdominal Preperitoneal (TAPP) and Lichtenstein operation for primary inguinal hernia repair – An institutional study.
J Soc Surg Nep, [S.l.], v. 25, n. 1, p. 16-21, aug. 2022.
ISSN 2392-4772.
Available at: <https://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=494>. Date accessed: 01 dec. 2023.
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