Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair:: A prospective randomized controlled trial

Background. This study was designed to compare an open tension-free technique (Lichtenstein repair) with a laparoscopic totally extroperitoneal hernia repair (TEP). Methods. One hundred sixty-eight men aged 30 to 65 years with primary or recurrent inguinal hernia were randomized to TEP or open mesh technique in the manner of Lichtenstein. Follow-up was after I and 6 weeks, and I year Results. Eighty-one patients were randomized to TEP, and 8 7 to open repair For I patient in each. group, the operation was converted to a different type of repair No difference was seen in overall complications between the 2 groups. However, 1 patient in the TEP group underwent operation for small bowel obstruction after surgery. A higher frequency of postoperative hematomas was seen in the open group (P < .05). Patients in the TEP group consumed less analgesic after surgery (P < . 001), returned to work earlier (P < . 01), and had a shorter time to full recovery (P < .01). Two recurrences occurred in the TEP group I year after surgery. Conclusion. The TEP technique was associated with less postoperative pain,' a shorter time to full recovery, and an earlier return to work compared with the open tension-free repair. No difference was seen in overall complications. However, 2 recurrences did occur after 1 year in the TEP group.