Totally extraperitoneal inguinal hernia repair versus Lichtenstein repair: a one-year follow-up study

Abstract

Totally extraperitoneal inguinal hernia repair versus Lichtenstein repair: a one-year follow-up study H. O. Havrylov 1, O. V. Shulyarenko 2 1 Clinic «Medikom», Kyiv 2 Bogomolets National Medical University, Kyiv  Oleg Shulyarenko: oleg.v.shu@gmail.com H. O. Havrylov, http://orcid.org/0000-0002-8425-8134 O. V. Shulyarenko, http://orcid.org/0000-0002-6780-8587 The inguinal hernia has an incidence of 27 — 43 % in males. Surgical repair is the most accepted treatment to prevent the development of complications. Laparoscopic inguinal hernia repair has become popular worldwide and includes the use of a laparoscopic technique for mesh placement behind the defect. OBJECTIVE — to assess whether totally extraperitoneal (TEP) inguinal hernia repair shows benefits over Lichtenstein repair in intraoperative and one-year follow-up postoperative outcomes for male patients with primary unilateral inguinal hernia. MATERIALS AND METHODS. 53 males were randomly allocated to two groups. Group 1 included 27 patients who underwent totally extraperitoneal hernia repair using self-gripping lightweight mesh, and group 2 included 26 patients who were treated surgically with Lichtenstein repair using lightweight mesh. RESULTS. Both groups were comparable in mean age, type of hernia, body mass index and patient’s distribution according to the European hernia society classification. TEP repair takes on average a little less time as compared to Lichtenstein repair, and this difference is not statistically significant. The mean of visual analogue scale for pain scoring in the first 24 hours after surgery as well as in the next 24 hours is statistically significantly smaller in group 1 compared to group 2. The mean time taken to return to work was 2.15 times longer in group 2 than in group 1, and the difference was statistically significant. CONCLUSIONS. Totally extraperitoneal hernia repair shows potential benefits over Lichtenstein repair for primary unilateral inguinal hernias as it causes less pain in the postoperative period and ensures early return to work. KEYWORDS totally extraperitoneal hernia repair, Lichtenstein repair, inguinal hernia, surgery