A RETROSPECTIVE COHORT STUDY ASSESSING TRANS-ABDOMINAL PRE-PERITONEAL PROCEDURE VERSUS LICHTENSTEIN APPROACH FOR INGUINAL HERNIA REPAIR
DOI:
https://doi.org/10.22159/ajpcr.2025v18i4.54042Keywords:
Lichtenstein inguinal hernia repair, Trans-abdominal pre-peritoneal procedure, Laparoscopy, Pain in inguinal regionAbstract
Objective: Inguinal hernia is a common pathology diagnosed predominantly clinically in males as well as females. Imaging, preferably with ultrasound is indicated when the diagnosis is uncertain, or complicated inguinal hernia. Surgery is the only definitive treatment for inguinal hernia. Apart from the classical open inguinal hernia repairs, minimal access approaches are also increasingly preferred. However, the optimal surgical approach still remains controversial as both techniques have some pros and cons. To compare the effectiveness of inguinal hernia repair utilizing the trans-abdominal pre-peritoneal repair (TAPP) and the Lichtenstein repair.
Methods: A retrospective study was planned, including 110 patients with unilateral or bilateral inguinal hernias admitted to the general surgery department of a tertiary care Centre. 42 patients who underwent the TAPP approach and 68 patients who underwent the Lichtenstein procedure were included in the study retrospectively. Using an institutional Hernia follow-up registry and telephonic conversations with patients, the incidence of post-operative pain and other complications were noted and compared.
Results: TAPP for inguinal hernias outperformed Lichtenstein in terms of post-operative discomfort and incidence of pain without increasing complications or recurrence rates.
Conclusion: TAPP surpassed the Lichtenstein operation in terms of post-operative discomfort and medication use for therapeutic intervention without increasing complication and recurrence rates.
Downloads
References
HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017- 1668-x, PMID 29330835
Savlovschi C, Brănescu C, Serban D, Tudor C, Găvan C, Shanabli A, et al. Amyand’s hernia--a clinical case. Chirurgia (Bucur). 2010 May- Jun;105(3):409-14. PMID 20726311
Sofi J, Nazir F, Kar I, Qayum K. Comparison between TAPP and Lichtenstein techniques for inguinal hernia repair: A retrospective cohort study. Ann Med Surg (Lond). 2021 Dec 01;72:103054. doi: 10.1016/j.amsu.2021.103054, PMID 34934481
Novitsky YW, Czerniach DR, Kercher KW, Kaban GK, Gallagher KA, Kelly JJ, et al. Advantages of laparoscopic transabdominal preperitoneal herniorrhaphy in the evaluation and management of inguinal hernias. Am J Surg. 2007 Apr 01;193(4):466-70. doi: 10.1016/j. amjsurg.2006.10.015, PMID 17368290
Pikoulis E, Tsigris C, Diamantis T, Delis S, Tsatsoulis P, Georgopoulos S, et al. Laparoscopic preperitoneal mesh repair or tension-free mesh plug technique? A prospective study of 471 patients with 543 inguinal hernias. Eur J Surg. 2002;168(11):587-91. doi: 10.1080/11024150201680003, PMID 12699093
Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343-403. doi: 10.1007/s10029-009-0529-7, PMID 19636493
McCormack K, Scott NW, Go PM, Ross S, Grant AM. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;2003(1):CD001785.
Pokorny H, Klingler A, Schmid T, Fortelny R, Hollinsky C, Kawji R, et al. Recurrence and complications after laparoscopic versus open inguinal hernia repair: Results of a prospective randomized multicenter trial. Hernia. 2008;12(4):385-9. doi: 10.1007/s10029-008-0357-1, PMID 18283518
Abbas AE, Abd Ellatif ME, Noaman N, Negm A, El-Morsy G, Amin M, et al. Patient-perspective quality of life after laparoscopic and open hernia repair: A controlled randomized trial. Surg Endosc. 2012;26(9):2465-70. doi: 10.1007/s00464-012-2212-9, PMID 22538670
Sultan AA, Abo Elazm HA, Omran H. Lichtenstein versus transabdominal preperitoneal (TAPP) inguinal hernia repair for unilateral non recurrent hernia: A multicenter short term randomized comparative study of clinical outcomes. Ann Med Surg (Lond). 2022 Apr 01;76:103428. doi: 10.1016/j.amsu.2022.103428, PMID 35345792
Takayama Y, Kaneoka Y, Maeda A, Takahashi T, Uji M. Laparoscopic transabdominal preperitoneal repair versus open mesh plug repair for bilateral primary inguinal hernia. Ann Gastroenterol Surg. 2020;4(2):156-62. doi: 10.1002/ags3.12314, PMID 32258981
Aiolfi A, Cavalli M, Micheletto G, Lombardo F, Bonitta G, Morlacchi A, et al. Primary inguinal hernia: Systematic review and Bayesian network meta-analysis comparing open, laparoscopic transabdominal preperitoneal, totally extraperitoneal, and robotic preperitoneal repair. Hernia. 2019;23(3):473-484. doi: 10.1007/s10029-019-01964-2, PMID 31089835
Published
How to Cite
Issue
Section
Copyright (c) 2025 Mohit Kumar Badgurjar

This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.