Comparison Of Tapp And Open Mesh Hernioplasty For Inguinal Hernias

Abstract

Background: The objective is to determine the outcome of TAPP and Open Methods
(Lichtenstein) for inguinal Hernia repair in terms of post operative pain, hospital stay, wound
infection and recurrence. TAPP technique is newer modality in the treatment of laparoscopic
hernia repair. With advantages over open methods of repair and various potential complications
along with greater learning curve it has point of interest for various studies. This study focuses on
100 patients undergoing hernia repair by either method, and elaborating the outcome in terms of
pain, operative time, wound infection and recurrence.
Materials and Method:Atotal of 100 patients were operated on between July 2005 and August
2010. They were divided into group A for TAPP mesh hernioplasty and group B for Lichtenstein
tension free mesh hernioplasy, 50 patients in each group. All the patients were followed up at 1, 6,
12 and 24 months for outcome measures.
Results:Atotal of 100 male patients with mean age 50.4 underwent hernia repair. There were 58
indirect, 31 direct and 11% mixed types of inguinal hernias. The mean operating time for TAPP
was 104.7 higher than in the open technique Mean=35.7 minutes. Post operative pain in majority
of TAPP group was mild in 40 (80%) patients and for open technique was moderate in 27 (54%).
The infection rate for the Open technique was 10%. Of the TAPP group 4 patients (8%) had early
recurrence, and 1 (2%) patient in the open technique presented with recurrence after 12 months
follow up.
Conclusion: TAPP technique for inguinal hernia repair is better than Open repair with regards
to less pain and early mobilization of patients. The rate of infection is also less. The disadvantages
include longer learning curve but it tends to vary in various centers. So the emphasis remains on
the need for developing a learning environment for such techniques in order to provide better
patient care.