SKIMS EXPERIENCE OF TEP VS LICHTENSTEIN REPAIR OD INGUINAL HERNIA

Abstract

Background: The word “hernia” is derived from a Latin term meaning “a rupture. ” A hernia is defined as an area of weakness or complete disruption of the fibromuscular tissues of the body wall. Structures arising from the cavity contained by the body wall can pass through, or herniate, through such a defect. Inguinal hernia, is the most common external abdominal hernia; approximately 75% of abdominal wall hernias occur in the groin and inguinal hernia comprises of 95% of all groin hernias and is nine times more common in men than in women.

Objectives: To compare the outcome of inguinal hernia repair using TEP & LICHTENSTEIN Technique of mesh repair in terms of: Operating time, Post-operative Hospital stay, Return to work, Cost Effectiveness, Complications, Cosmesis, and Detection of clinically insignificant (occult) hernia on the contralateral side in TEP.

Study Design: Prospective Randomised comparative study.

Materials & Methods: The study included a total of 100 patients, 50 in TEP and 50 in Lichtenstein group, aged 18 to 75 years admitted for elective inguinal hernia repair. The study was undertaken to compare the outcomes in patients following TEP & Lichtenstein’s technique of tension free mesh groin hernia repair.

Results: In our study we found that operative time was greater in TEP compared to Lichtenstein in unilateral cases, but in bilateral cases operative time was more in Lichtenstein group. The hospital stay and return to work was lower in TEP group compared to Lichtenstein group. The pain scores on post-operative day 0, 1 and day 7 were significantly lower in case of TEP group compared to Lichtenstein group. The overall complication rate in the TEP group was 8% while in the Lichtenstein group it stood at 24%.

Conclusion: TEP repair is associated with an earlier toleration of oral feeds, lesser post-operative pain, earlier discharge from the hospital, earlier return to usual activities and less persisting pain. There is no significant difference in the complication rate between the two techniques but there are higher chances of serious complications in TEP technique. TEP repair is costlier for the patient as compared to Lichtenstein repair.