Outcome of Laparoscopic (TEP) Versus Open (Lichtenstein) Inguinal Hernia Repair: Six-year Follow Up
Keywords:
Laparoscopic, TEP, Lichtenstein, Inguinal Hernia, Complications, RecurrenceAbstract
Objective: To compare the results of laparoscopic totally extraperitoneal procedures (TEP) and Lichtensteininguinal hernia repairs.
Patients and Methods: Inguinal hernia repairs performed between January 2008 and December 2013 at Maharat
Nakhon Ratchasima Hospital were reviewed. The only exclusion criterion was obstructed hernia. All patients were
followed at 2 weeks, 6 weeks, 6 months and every year until 5 years.
Results: A total of 286 patients were included; 178 cases underwent open Lichtenstein technique, and 108 cases
underwent laparoscopic TEP. There were no significant differences between groups in gender (P = 0.186), type of
hernia (P = 0.250), hospital stay (P = 0.162), complications (P = 0.491), and recurrence rate (P = 0.999). Laparoscopic
TEP repair was advantageous in terms of less postoperative pain and faster return to normal activity (P < 0.001), but
open Lichtenstein repair was superior in terms of shorter operative time (P < 0.001).
Conclusion: Laparoscopic TEP inguinal hernia repair is safe, and more advantageous in terms of less postoperative
pain and faster return to normal activity when compared with the open Lichtenstein inguinal hernia repair,
while no differences in terms of complications and recurrent hernia could be detected.
References
1. McCormack K, Scott NW, Go PM, et al. for the EU Hernia
Trialists Collaboration. Laparoscopic techniques versus open
techniques for inguinal hernia repairs. Cochrane Database
Syst Rev 2003;(1):CD001785.
2. Kuhry E, van Veen RN, Langeveld HR. Open or endoscopic
total extraperitoneal inguinal hernia repair? A systematic
review. Surg Endosc 2007;21:161-6.
3. Lichtenstein IL, Shulman AG, Amid PK, et al. The tension-free
hernioplasty. Am J Surg 1989;157:188-93.
4. Douek M, Smith G, Oshowo A, et al. Prospective randomised
controlled trial of laparoscopic versus open inguinal hernia
mesh repair: five year follow up BMJ 2003;326:1012-3.
5. El-Dhuwaib Y, Coreless D, Emmett C, et al. Laparoscopic
versus open repair of inguinal hernia: a longitudinal cohort
study. Surg Endosc 2013;27:936-45.
6. Brunicardi F, Andersen D, Billiar T, et al, eds. Schwartz’s
principles of surgery. 9th ed. New York: McGraw-Hill;2011:1334
7. Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes
and complications of open vs laparoscopic extraperitoneal
inguinal hernia repair in a mature surgical practice. Surg
Endosc 2004;18:221-7.
8. Koning GS, deSchipper LtI, Oostvogel HJM, et.al. The Tilburg
double blind randomized controlled trial compairiry inguinal
hernia repair according to Lichtenstein and the transinguinal
preperi toneal technique. Trial 2009;10:89 doi:10.1186/1745-
6215-10-89.
9. Finley RK Jr, Miller SF, Jones LM. Elimination of urinary retention
following inguinal herniorrhaphy. Am Surg 1991;57:486-8.
10. McClusky DA III. Urinary retention after laparoscopic inguinal
hernia repair. In: Jacob BP, Ramshaw B, eds. The SAGES
Manual of Hernia Repair. New York: Springer; 2013:157-66.
11. Lal P, Kajla RJ, Chander J, et al. Randomized controlled
study of laparoscopic total extraperitoneal vs. open
Lichtenstein inguinal hernia repair. Surg Endosc 2003;17:850-
6.
12. Vidovic D, Kirac I, Glaran E. Laparoscopic totally extraperitoneal
hernia repair vs. open Lichtenstein hernia repair:
results and complications. J Laparosc Adv Surg Tech
2007;17:585-90.
13. Rosenbery J, Vielsen BM. Current status of laparoscopic
inguinal hernia repair in Denmark. Hernia 2008;12:583-7.
14. NICE. Implementation uptake report:Laparoscopic Surgery
for inguinal hernia repair. http://www.nice.org.UK/media/
D74/57/update Report Lap Hernia Publication April
2009.pdf.Accessed 7 Feb 2012
15. NICE. Laparoscopic surgery for inguinal hernia repair. NICE
technology appraisal 83 2004. http://publications.nice.
org.UK/laparoscopic-surgery-for-inguinal-hernia-repair-ta83.
Accessed 7 Feb 2012
16. Pokorny H. Klingler A, Schmid T, et al. Recurrence and
complication after laparoscopic versus open inguinal hernia
repair: results of a prospective randomized mulicenter trial.
Hernia 2008;12:385-9.
17. Wullstein C, Strey C, Woeste G, Bechstein kio(2008) Inguinal
hernia:Laparoscopic or open surgery? Zentrallbl Chir 133:433-
439
18. Darzi A, Paraskeva, PA, Quereshi A, et al. Laparoscopic
herniorrhaphy: initial erperience in 126 patients. J Laparosc
Surg 2008;4:179-83.
19. Phillips EH, Arregui M, Carroll BJ, et al. Incidence of
complication following laparoscopic hernioplasty. Surg
Endosc 1995;9:16-21.
20. Kald A, Anderberg B, Smedh K, et al. Transperitoneal or
totally extraperitoneal approach in Laparoscopic hernia
repair : result of 491 consecutive herniorrhaphies. Surg
Laparosc Endosc 1997;7:86-9.
21. Menon MA, Cooper NJ, Menon B, et al. Meta-analysis of
randomized clinical trials comparing open and laparoscopic
inguinal hernia repair. Br J Surg 2003;90:1479-92.
22. Edwards CC II, Bailey RW. Laparoscopic hernia repair: the
learning curve. Surg Laparosc Endosc Percutan Tech
2000;10;149-53.
23. Medical Research Council Laparoscopic Groin Hernia Trial
Group. Cost-utility analysis of open versus laparoscopic
groin hernia repair: results from a multicentre randomized
clinical trial. Br J Surg 2001;88:653-61.
24. Stoppa RE, Warlaumount CK. the preperitoneal approach
and prosthesis repair of groin hernia. In: Nyhus LM, Coldon
RE, eds. Hernia 4th ed. Philadelphia: JB Lippincott; 1995:118-
210.
25. EU Hernia Trialists Collaboration. Mesh compared with non
mesh methods of open grain hernia repair: systematic
review of randomized controlled trials. Br J Surg 2000;87:854-
9.
26. Scott NW, Mccormack K, Graham P, et al. Open mesh
versus non mesh for repair of femoral and inguinal hernia.
Cochrane Database Syst Rev 2002;(4):CD002197.
27. Li J, Ji Z, Li Y. Comparison of recurrent inguinal hernia: a
meta-analysis of the results. Am J Surg 2014;207:602-12.
28. Carazzok LT, Rosen MJ. Laparoscopic versus open inguinal
hernia repair. Surg Clin N Am 2013;93:1269-79.
29. Bringman S, Ramel S, Heikkinen TJ. Tension-free inguinal
hernia repair: TEP versus mesh-plug versus Lichtenstein. A
prospective randomized controlled trial. Ann Surgery
2003;237:142-7.
30. Lal P, Kajla RK, Chander J, et al. Randomized controlled
study of laparoscopic total repair. Surg Endosc 2003;17:850-
6.
31. Koning GG, Welterslev JC, van Laarhoven JHM, et al. The
totally extraperitoneal method versus Lichtenstein’s
technique for inguinal hernia repair: A systematic review
with meta-analysis and trial sequential analyses of
randomized clinical trials. PLOS One 2013;18:e52599
32. Zhu X, Cao H, Ma Y. Totally extraperitonean laparoscopic
hernioplasty versus open extraperitoneal approach for
inguinal hernia repair: A meta-analysis of outcome of our
current knowledge. Surgeon 2014;12:94-105.
Trialists Collaboration. Laparoscopic techniques versus open
techniques for inguinal hernia repairs. Cochrane Database
Syst Rev 2003;(1):CD001785.
2. Kuhry E, van Veen RN, Langeveld HR. Open or endoscopic
total extraperitoneal inguinal hernia repair? A systematic
review. Surg Endosc 2007;21:161-6.
3. Lichtenstein IL, Shulman AG, Amid PK, et al. The tension-free
hernioplasty. Am J Surg 1989;157:188-93.
4. Douek M, Smith G, Oshowo A, et al. Prospective randomised
controlled trial of laparoscopic versus open inguinal hernia
mesh repair: five year follow up BMJ 2003;326:1012-3.
5. El-Dhuwaib Y, Coreless D, Emmett C, et al. Laparoscopic
versus open repair of inguinal hernia: a longitudinal cohort
study. Surg Endosc 2013;27:936-45.
6. Brunicardi F, Andersen D, Billiar T, et al, eds. Schwartz’s
principles of surgery. 9th ed. New York: McGraw-Hill;2011:1334
7. Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes
and complications of open vs laparoscopic extraperitoneal
inguinal hernia repair in a mature surgical practice. Surg
Endosc 2004;18:221-7.
8. Koning GS, deSchipper LtI, Oostvogel HJM, et.al. The Tilburg
double blind randomized controlled trial compairiry inguinal
hernia repair according to Lichtenstein and the transinguinal
preperi toneal technique. Trial 2009;10:89 doi:10.1186/1745-
6215-10-89.
9. Finley RK Jr, Miller SF, Jones LM. Elimination of urinary retention
following inguinal herniorrhaphy. Am Surg 1991;57:486-8.
10. McClusky DA III. Urinary retention after laparoscopic inguinal
hernia repair. In: Jacob BP, Ramshaw B, eds. The SAGES
Manual of Hernia Repair. New York: Springer; 2013:157-66.
11. Lal P, Kajla RJ, Chander J, et al. Randomized controlled
study of laparoscopic total extraperitoneal vs. open
Lichtenstein inguinal hernia repair. Surg Endosc 2003;17:850-
6.
12. Vidovic D, Kirac I, Glaran E. Laparoscopic totally extraperitoneal
hernia repair vs. open Lichtenstein hernia repair:
results and complications. J Laparosc Adv Surg Tech
2007;17:585-90.
13. Rosenbery J, Vielsen BM. Current status of laparoscopic
inguinal hernia repair in Denmark. Hernia 2008;12:583-7.
14. NICE. Implementation uptake report:Laparoscopic Surgery
for inguinal hernia repair. http://www.nice.org.UK/media/
D74/57/update Report Lap Hernia Publication April
2009.pdf.Accessed 7 Feb 2012
15. NICE. Laparoscopic surgery for inguinal hernia repair. NICE
technology appraisal 83 2004. http://publications.nice.
org.UK/laparoscopic-surgery-for-inguinal-hernia-repair-ta83.
Accessed 7 Feb 2012
16. Pokorny H. Klingler A, Schmid T, et al. Recurrence and
complication after laparoscopic versus open inguinal hernia
repair: results of a prospective randomized mulicenter trial.
Hernia 2008;12:385-9.
17. Wullstein C, Strey C, Woeste G, Bechstein kio(2008) Inguinal
hernia:Laparoscopic or open surgery? Zentrallbl Chir 133:433-
439
18. Darzi A, Paraskeva, PA, Quereshi A, et al. Laparoscopic
herniorrhaphy: initial erperience in 126 patients. J Laparosc
Surg 2008;4:179-83.
19. Phillips EH, Arregui M, Carroll BJ, et al. Incidence of
complication following laparoscopic hernioplasty. Surg
Endosc 1995;9:16-21.
20. Kald A, Anderberg B, Smedh K, et al. Transperitoneal or
totally extraperitoneal approach in Laparoscopic hernia
repair : result of 491 consecutive herniorrhaphies. Surg
Laparosc Endosc 1997;7:86-9.
21. Menon MA, Cooper NJ, Menon B, et al. Meta-analysis of
randomized clinical trials comparing open and laparoscopic
inguinal hernia repair. Br J Surg 2003;90:1479-92.
22. Edwards CC II, Bailey RW. Laparoscopic hernia repair: the
learning curve. Surg Laparosc Endosc Percutan Tech
2000;10;149-53.
23. Medical Research Council Laparoscopic Groin Hernia Trial
Group. Cost-utility analysis of open versus laparoscopic
groin hernia repair: results from a multicentre randomized
clinical trial. Br J Surg 2001;88:653-61.
24. Stoppa RE, Warlaumount CK. the preperitoneal approach
and prosthesis repair of groin hernia. In: Nyhus LM, Coldon
RE, eds. Hernia 4th ed. Philadelphia: JB Lippincott; 1995:118-
210.
25. EU Hernia Trialists Collaboration. Mesh compared with non
mesh methods of open grain hernia repair: systematic
review of randomized controlled trials. Br J Surg 2000;87:854-
9.
26. Scott NW, Mccormack K, Graham P, et al. Open mesh
versus non mesh for repair of femoral and inguinal hernia.
Cochrane Database Syst Rev 2002;(4):CD002197.
27. Li J, Ji Z, Li Y. Comparison of recurrent inguinal hernia: a
meta-analysis of the results. Am J Surg 2014;207:602-12.
28. Carazzok LT, Rosen MJ. Laparoscopic versus open inguinal
hernia repair. Surg Clin N Am 2013;93:1269-79.
29. Bringman S, Ramel S, Heikkinen TJ. Tension-free inguinal
hernia repair: TEP versus mesh-plug versus Lichtenstein. A
prospective randomized controlled trial. Ann Surgery
2003;237:142-7.
30. Lal P, Kajla RK, Chander J, et al. Randomized controlled
study of laparoscopic total repair. Surg Endosc 2003;17:850-
6.
31. Koning GG, Welterslev JC, van Laarhoven JHM, et al. The
totally extraperitoneal method versus Lichtenstein’s
technique for inguinal hernia repair: A systematic review
with meta-analysis and trial sequential analyses of
randomized clinical trials. PLOS One 2013;18:e52599
32. Zhu X, Cao H, Ma Y. Totally extraperitonean laparoscopic
hernioplasty versus open extraperitoneal approach for
inguinal hernia repair: A meta-analysis of outcome of our
current knowledge. Surgeon 2014;12:94-105.
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Published
2015-03-30
How to Cite
1.
Wisanuyothin T. Outcome of Laparoscopic (TEP) Versus Open (Lichtenstein) Inguinal Hernia Repair: Six-year Follow Up. Thai J Surg [Internet]. 2015 Mar. 30 [cited 2024 Apr. 19];36(1). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226243
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