Abstract

OPEN VERSUS LAPAROSCOPIC HERNIA – A TELLTALE FIGHT FOR SURGICAL SUPREMACY….WHO WINS?

Anil Raj D.* and Veeresh M. Annigeri

ABSTRACT

Introduction: Inguinal hernia repair has been one of the most common operations performed by general surgeons for years. The most significant advances to impact inguinal hernia repair have been the addition of prosthetic materials to conventional repair and the introduction of laparoscopy to general surgical procedures. Over the years, surgeons all over the world have tried various techniques for repair of inguinal hernias. Each procedure had its own advantages and disadvantages. This clinical study was undertaken to study the comparison of open and laparoscopic inguinal hernias repair and their postoperative complications. Objectives: To compare the Open & Laparoscopic method of Mesh Repair of Inguinal Hernia with respect of the following outcomes:  Duration of the Procedure  Postoperative Discomfort or Pain.  Complications Per operative & Postoperative.  Duration of Hospitalization.  Time to return to normal activities. Material and Methods: Study was conducted in Department of General surgery, PK Das Institute of Medical Sciences, Vaniamkulam, Palakkad, Kerala, during the period of August 2015 to July 2017. 100 cases of diagnosed inguinal hernias were selected & randomly allotted, 75 cases to Open Lichtenstein Tension-Free Hernia Repair group & 25 cases to Laparoscopic TEP group, information was collected. Collected data analyzed by SPSS software with Pearson Chi-square test & independent sample t- test. Results: In our study mean operating time in Open group is 48.53mins & in TEP group is 76.80mins.The incidence of per & post-operative complications was significantly different in the two groups with Pearson Chi-Square value14.585 & p value 0.042. TEP group had lesser duration of Post-Operative Pain which has statistically significant Pearson Chi-Square value 7.367 & p value < 0.025, lesser duration of hospital stay which has statistically significant t value 3.830 & p value <0.001, lesser Time to return to normal activities which has statistically significant t value 4.520 & p value <0.001. Conclusion: The number of patients in this study and the short duration of study are the major limitations of this study. Though TEP repair is more time consuming than Open Lichtenstein Repair, it is associated with statistically significant different complications profile, lesser post-operative time, lesser duration post-operative hospital stay, & earlier return to normal activities. Hence the overall benefit is better in the TEP repair than the open repair for inguinal hernias.

Keywords: Inguinal hernia, Mesh Repair, Minimally Invasive, TEP repair, Laparoscopic Surgery, Inguinal Hernia, Pearson Chi-square test, Lichtenstein Repair.