Comparison of the Perioperative QOL in Inguinal Hernia Surgery Between Laparoscopic and Open Surgery

Masahiro Ishizaki, MD, R Sugimoto, MD, N Iga, MD, R Yoshida, MD, H Ikeda, MD, N Waki, MD, H Kawai, MD, H Nishi, MD, K Yamashita, MD. Okayama Rosai Hospital

INTRODUCTION – Laparoscopic repairs are getting mainstream in inguinal hernia surgery. There are some opinions that the early and chronic QOL are better in laparoscopic surgery than open surgery, but those have not been evaluated properly. So we made questionnaires about QOL after surgery and compared the VAS scores between laparoscopic and open surgery.

METHODS AND PROCEDURES –110 patients (101 males and 9 females) had inguinal hernia repairs in our hospital from December 2013 to September 2015. Sixty six patients had laparoscopic surgery (13 both sides) and 44 had open surgery (2 both sides). All laparoscopic surgeries were TAPP procedures. Open operations contain 33 transinguinal preperitoneal repairs (polysoft), and 11 mesh plug repairs. Medical secretaries gave questionnaires to those patients at 1-3 days after surgery, and at 2-3 weeks after surgery (at first outpatient visit). VAS (Visual analog scale) scores were collected by medical secretary. Questions are about Disturbance with walking, Sensing of bloating, Pain, Sensing of foreign body, and Swelling of wound. We used T-Test to evaluate the VAS scales.

RESULTS –Mean operative time was 145.4 and 69.5 minutes in laparoscopic group and open group respectively. The mean admission periods after surgery was 4.2 and 3.1 days. P values of T-test of VAS scores concerning Disturbance with walking, Sensing of bloating, Pain, Sensing of foreign body, and Swelling of wound in 3 days were 0.01, 0.002, 0.01, 0.75 and 0.59 respectively, in favor of open group. But P values of VAS scores in 3 weeks were 0.92, 0.66, 0.49, 0.09 and 0.24 respectively, without any differences between those two groups. Some researchers reported that laparoscopic hernia repair induces less pain than open hernia repair. In ours series of 110 patients early QOL with Disturbance with walking, Sensing of bloating, Pain was statistically better in open group. Perioperative QOL of open inguinal hernia surgery was not inferior to laparoscopic surgery.

CONCLUSION(S) –Open inguinal hernia surgery should be reevaluated to be chose in day surgery. We need to experience more cases and explore the early and long term QOL of both procedures to find out the best operations for inguinal hernia.

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