Early outcomes of laparoscopic totally extraperitoneal hernia repair versus open tension-free mesh hernioplasty

Abstract

Surgical techniques of inguinal hernia repair have been evolving over the past decade. We conducted the present study to compare the early outcomes of laparoscopic totally extraperitoneal repair (TEP) and open tension-free mesh hernioplasty. A total of 72 patients with 80 inguinal hernias were recruited between April and September 1999. Group I consisted of 32 consecutive patients who underwent TEPs (bilateral repairs in 8 patients) while Group II comprised 40 consecutive patients who underwent unilateral open mesh hernioplasties. A prospective collection and analysis of data were performed. Post-operative complications included seroma (n = 1), wound bruising (n =1) and retention of urine (n = 1) in Group I. Post-operative morbidity in Group II comprised wound infection (n = 2), transient ischaemic attack (n = 1) and seroma (n = 1). Comparison between the two groups showed no statistically significant difference. The maximal pain scores on postoperative days one, two and three of the two groups were comparable (P = ns) but patients who underwent open repairs required significantly more analgesics than the TEP group (P < 0.05). The mean length of hospital stay following laparoscopic and open repairs was two and four days respectively (P < 0.05). The early outcomes of laparoscopic totally extraperitoneal repair were superior to open mesh hernioplasty, with regard to the analgesic requirements and length of hospital stay.