Open Tension-free Mesh-plug Versus Transabdominal Preperitoneal(tapp) Versus Totally Extraperitoneal(tep) Laparoscopic Techniques for Primary Unilateral Inguinal Hernia Repair: A Prospective Randomized Controlled Trial

Background Open tension-free mesh-plug hernia repair, transabdominal preperitoneal(TAPP) and totally extraperitoneal(TEP) laparoscopic techniques are common surgical procedures for primary unilateral inguinal hernia repair. However, the choice of surgical procedure is still controversial in China.
Objective To compare open tension-free hernioplasty with two laparoscopic hernia repairs. Methods One hundred sixty-four male patients suffering from primary unilateral inguinal hernia were randomized to undergo open operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty (TAPP) or totally extraperitoneal hernioplasty (TEP). Results It took this research three years from February 2006 to February 2009 to complete. Among the total 164 patients, 62 underwent open tension-free mesh-plug hernia repair( a mean age of 54 years), 50 undertook TAPP (a mean age of 56 years) and 52 undertook TEP (a mean age of 57 years). The patients were followed for 15.6±7.4 months. The mean operating time was significantly shorter in open mesh repair group (P<0.001) compared to the other two groups. The cost of the open mesh repair was significantly lower in open mesh repair group(P<0.001) than in other two groups. However the pain scores at 24h, 1 week were significantly higher in open mesh repair group (P<0.001)than in other two groups. The hospital stay and the time to resumption of normal activities were significantly longer in open mesh repair group (P<0.001) compared to the other two groups. No major complications and recurrence was found in all groups. There were no significant differences in the major complications and recurrence in all groups. Conclusions This research concludes that open tension-free mesh-plug hernia repair, TAPP and TEP are safe and effective to the patients who suffered from primary unilateral inguinal hernia. For primary unilateral inguinal hernia TAPP and TEP are superior to open tension-free mesh-plug hernia repair in terms of less postoperative pain and faster return to normal activity and laparoscopic repair techniques are a recommendable choice of surgical procedure. Whereas open repair is still an option in China considering lower financial cost and no requirement of a long learning period and special equipment.

Session: Podium Presentation

Program Number: S026

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