Akhtar Ghani, Jawad Khalil, Muhammad Imran Khan, Hameed Khan.
Laparoscopic transabdominal preperitoneal versus lichtenstein tension free repair for inguinal hernia.
Pak J Surg Jan ;28(1):06-11.

Introduction: Chronic groin pain is a common complaint aft er repair of inguinal hernia. Th is pain most frequently is due to iatrogenic damage or entrapment of the nerves, in and around the inguinal canal, the most important of which is the ilioinguinal nerve. Objective: To compare the two tension-free methods of hernia repair: trans-abdominal preperitoneal laparoscopic mesh repair and the open Lichtenstein mesh technique in terms of operative time, length of hospital stay and chronic post-operative pain. Study Design: Randomized controlled trial Sett ing and Duration: Surgical “C“ Unit, Khyber Teaching Hospital, Peshawar, Pakistan, May 2009 to December 2009. Materials and Methods: A total of 176 male patients, aged between 16-60 years, were divided into two groups, A and B, with patients being subjected to Transabdominal Pre-Peritoneal (TAPP) and Lichtenstein repairs, respectively. Th e two groups were compared for operative time, length of hospital stay, and chronic groin pain. Percentages were calculated for categorical data while numerical data were represented as mean ± SD. Chi square test and t test were used to compare categorical and numerical variables, respectively. Probability ≤ 0.05 (P ≤ 0.05) was considered signifi cant. Results: At one month interval, in group A mild, moderate and severe pain was observed in 23 (26.1%), 6 (6.8%) and 2 (2.3%) patients compared to 32 (36.4%), 18 (20.5%) and 8 (8.1%) patients, respectively, in group B. Mean operative duration was signifi cantly longer in group A compared to group B (P < 0.001). Mean hospital stay was signifi cantly longer in group B compared to group A (P < 0.001). Conclusion: Tran-abdominal pre-peritoneal laparoscopic inguinal hernia repair is eff ective in decreasing the incidence of chronic groin pain and post-operative hospital stay in comparison with Lichtenstein tension free mesh hernioplasty.

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