Comparison of the Lichtenstein technique and transabdominal pre-peritoneal hernia repair in geriatric patients.

Abstract

Introduction: This study aimed to compare the Lichtenstein technique and the transabdominal pre-peritoneal (TAPP) approach regarding safety and patient comfort in geriatric patients with inguinal hernia, and to evaluate the safety of laparoscopic surgery in this population.

Patients and methods: This prospective study included patients aged ≥65 years who were hospitalised with an inguinal hernia and underwent surgical repair. Pre-operative complete blood count and biochemical parameters, operation and anaesthesia durations, and length of hospital stay were recorded through retrospective chart review. Post-operative patient satisfaction was assessed using the ODOMS questionnaire during outpatient follow-up. Patients were divided into two groups according to surgical technique: Lichtenstein repair and TAPP procedure.

Results: A total of 125 patients developed complications. Among these, 110 cases (25.3%) occurred in the Lichtenstein group and 15 cases (3.4%) in the TAPP group, indicating a significantly lower complication rate with the laparoscopic approach ( P < 0.001). There were no statistically significant differences between groups in terms of ASA scores, anaesthesia duration or operative time ( P = 0.196 and P = 0.082, P = 0.147). However, the length of hospital stay was significantly shorter in the TAPP group ( P = 0.014). In addition, patient satisfaction scores measured by the ODOMS questionnaire were significantly higher in the TAPP group ( P = 0.003).

Conclusion: Laparoscopic TAPP repair appears to be a safe and effective alternative to open Lichtenstein repair in geriatric patients. It is associated with fewer complications, shorter hospitalisation, and higher patient satisfaction, without increasing operative or anaesthesia duration.