FOUR ARM RANDOMISED TRIAL COMPARING LAPAROSCOPIC AND OPEN HERNIA REPAIRS | ||
| The Egyptian Journal of Surgery | ||
| Volume 28, Issue 3, July 2009, Pages 110-117 PDF (170.09 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2009.367595 | ||
| Authors | ||
| Yasser Hamza* ; Esam Gabr; Habashi Hammadi; Rafik Khalil | ||
| Department of Surgery, Faculty of Medicine, University of Alexandria | ||
| Abstract | ||
| Aim: To compare four approaches in primary repair of inguinal hernia as regards operative and postoperative outcome. Methods: One hundred consecutive patients with primary inguinal hernia Nyhus I-III were randomized into four groups. Group I had Open pro-peritoneal repair, group II had Lichtenstein tension-free mesh repair, group III had Transabdominal pro-peritoneal repair (TAPP) while group IV had laparoscopic totally extraperitoneal hernia (TEP) repair. Results: Operative time ranged from 10.71 to 120.61 minutes. Laparoscopic operations were significantly longer than open operations (54.5+13.2, 34.21+23.5 versus 96.12+22.5, 77.4+43.21; t = 3.891, p <0.001). Open pro-peritoneal approach had significantly longer operative time compared to Lichtenstein approach (54.5+13.2 versus 34.21+23.5). Postoperative pain was significantly higher in patients who had open repairs (7.067+1.831, 6.5+3.5 versus 5.8 +1.568, 4.8+2.33; t = 3.424, p = 0.002). There was one case of conversion in each of the two laparoscopic groups. Laparoscopic operations were associated with significantly faster return to normal domestic activities and to work. Conclusion: Laparoscopic hernia repair offers less postoperative pain and rapid recovery on the expense of longer operative time. TEP and TAPP laparoscopic techniques gave similar results. | ||
| Keywords | ||
| Minimally invasive; Inguinal hernia; Pro-peritoneal repair | ||
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