Prospective study of laparoscopic totally extraperitoneal repair (TEP) & open mesh hernioplasty
Journal Title: International Journal of Allied Medical Sciences and Clinical Research - Year 2018, Vol 6, Issue 1
Abstract
Background Inguinal hernia repair by laparoscopy has gained much importance in the past decade as it has been shown to be associated with lesser incidence of morbidity and a faster postoperative recovery than open repair, however many laparoscopic surgeons are still reluctant to adopt this technique because of long learning curve. Materials and Methods This was a hospital based prospective study comparing the results of TEP & open hernia repair. The study was conducted in the Department of General Surgery, Hamdard Institute of Medical Sciences and Research, New Delhi. Data from all the patients was collected prospectively over a period of 2 years from June 2015 to June 2017. A total of 160 patients were enrolled in the study. Patients were divided into laparoscopic (Group A) and open hernia repair group (Group B) strictly based on patient preference and anaesthetic risks after meeting the inclusion criteria. Patients with uncomplicated, unilateral/bilateral inguinal hernia were included in the study. Polypropylene mesh was used in both procedures. Tacks were used in TEP for the fixation of mesh. Data collected was analysed and expressed as average, mean/median. Results All patients in our study were men in the age group of 20 to 60 years and above, with a mean age of 49 years in group A and 53 years in group B. All patients in our study had unilateral inguinal hernia. Postoperative pain was slightly more in group B (7.5%) than group A patients (2.5%). Postoperative urinary retention was found to be lower in group A (2.5%) compared to group B (7.5%). In our study 02 patients (2.5%) in group A developed postoperative seroma and same complication was found in 06 patients (7.5%) of group B. Our study found a superficial wound infection rate of 1.25% and 5% in groups A and B respectively. The average hospital stay in our study was 2.5 days in group A and 3 days in group B. The recurrence rate in group A and group B was 0% and 2.5% respectively. Laparoscopic repair was found to be slightly costlier than open hernia repair in our study. Conclusion Laparoscopic TEP repair is a safe option in expert hands for the repair of uncomplicated inguinal hernias. Although, slightly costly with marginally higher rate of recurrence, laparoscopic hernia repair has comparable results with open hernia repair with fewer general complications
Authors and Affiliations
Mohammad Mohsin Arshad
Keywords
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