A prospective randomized controlled trial of open Lichtenstein and totally extra-peritoneal repair in men with uncomplicated groin hernia

Abstract

Objective: The objective of this study is to compare laparoscopic totally extra-peritoneal repair (TEP) with Lichtenstein repair for inguinal hernia with regard to mean operative time, complications, postoperative pain, hospital stay, return to work, cosmetic effects (scar size), and recurrence rate. Patients and Methods: This was a prospective randomized controlled study conducted in a district hospital over a period of 3 years. One hundred and thirty-two patients of groin hernias were treated, 66 each by TEP repair and Lichtenstein tension-free repair. Patients were followed up for 1 year. Results: The mean operative time in laparoscopic TEP was 78.56 min against 58.12 min in Lichtenstein repair (P < 0.0001). The intraoperative complication rates did not differ significantly between the two techniques (P = 0.0612). The postoperative pain scores were significantly lesser in the TEP group (P < 0.0001). The postoperative hospital stay was similar in the two groups (P = 0.7125). There was no statistical difference in the total number of postoperative complications in the two groups(P = 0.8381). The TEP group had a smaller average scar size (P < 0.0001) and returned to their activities of daily life much earlier (P < 0.0001). The recurrence rates were, however, similar between the two groups (P = 0.7861). Conclusion: TEP offered a number of advantages over Lichtenstein repair and proved to be the sure winner.