Comparison of Open Lichenstien Mesh Repair and Transabdominal preperitoneal (TAPP)
Abstract
Background:
Laparoscopic Transabdominal preperitoneal [TAPP] repair of inguinal hernia has become more popular in recent years as minimally invasive surgery is getting hold in surgery. Although controversy still exists about the most effective inguinal hernia repair. The aim of this study was to compare the common complications of open lichenstien repair and TAPP.
Method
Between Oct 2018 to Oct 2021 patients with unilateral inguinal hernia and ASA grade 1&2 were selected to be included in the study in outpatient department and randomized prospectively into group-1 (TAPP repair), and group-2 (lichenstien open mesh repair).
Results:
A total of 80 patients were included in the study. Male 76 and Female 4. Age range was 24 to 68 years. Primary inguinal hernias were present in 68 cases while recurrent in 12. Post-operative pain was more in Liechestien group. Scrotal swelling was most common complication noted in group-2. Operative time was more in TAPP, 90 minutes as compared to 55 minutes in lichenstien group. Recurrence was more in group -2. Overall complication rate in group -2 was 14(17.5%) and in group -1 it was 2(2.5%).
Conclusion:
TAPP is a safe and effective alternative to open surgery with less complication and recurence rate. However, it has more operative time and steep learning curve.
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Introduction
Inguinal hernia repair is one of the most common surgical procedures performed all over the world and it has evolved over the years from tissue repair to Darning to mesh repair.1 Liechestien mesh repair was gold standard technique for quite a long time till the introduction of laproscopy. More recently with the popularity of minimally invasive surgery, surgeons are becoming more and more inclined towards the laproscopic approach.2,3
Laproscopic inguinal hernia surgery has started in 1990s and since then has been adopted with great fervor by the surgeons all over the world.4 There are different laproscopic approaches to the inguinal hernia like TAPP, TEP, IPOM. IPOM has recently fallen from favour as a procedure of choice for inguinal heria but TAPP and TEP has proved to be effective day by day.5,6 Although laproscopic surgery has many advantages over open it has disadvantages also. The learning curve is very steep and surgery time is almost double to open.7
TAPP is a well standardized procedure for inguinal hernia repair and its effectiveness is increased even more when it comes to the bilateral hernia and in case of recurrence if anterior repair has failed.8,9
Conclusion
This study confirms the safety and effectiveness of TAPP approach as compared to open repair. The reduction of operative time, complication and recurrence is correlated with the surgeon experience.