Skip to main content
SpringerLink
Log in

Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias: a prospective randomized study

  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background

The current prospective randomized controlled clinical study aimed to assess the short- and long-term results of recurrent inguinal hernia repair, and to compare the results for transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) procedures with those for open tension-free repair.

Methods

For this study, 82 patients were randomly assigned to undergo TAPP (group A, n = 24), TEP (group B, n = 26), or open Lichtenstein hernioplasty (group C, n = 32). All the patients with recurrent inguinal hernias had undergone previous repair using conventional open procedures. Physical examination showed Nyhus type II hernia in the vast majority of the patients (59%). High-risk patients (American Society of Anesthesiology [ASA] III or IV); coagulation disorders; previous abdominal or pelvic surgery; and irreducible, congenital, and massive scrotal or sliding hernias were excluded from the study.

Results

There was a statistically significant difference (p = 0.001) in operating time favoring the open procedure. The intensity of postoperative pain was greater in the open hernia repair group 24 h, 48 h, and 7 days after surgery (p = 0.001), with a greater consumption of pain medication among these patients (p < 0.004). The median time until return to work was 14 days for group A, 13 days for Group g, and 20 days for group C. The comparison was in favor of laparoscopically treated patients. Nine recurrences (4 in the laparoscopic groups and 5 in the open group) were documented within 3 years of follow-up evaluation.

Conclusion

Laparoscopic inguinal hernia repair (TAPP or TEP) is the method of choice for dealing with recurrent inguinal hernia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Neumayer I, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W, Veterans Affairs Cooperative Studies Program 456 Investigators (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 18: 1819–1827

    Article  Google Scholar 

  2. Jonasson O (2003) Introduction: inguinal hernia management-testing management strategies in two clinical trials. J Am Coll Surg 5: 735–736

    Article  Google Scholar 

  3. Macintyre IM (2003) Best practice in groin hernia repair. Br J Surg 2: 131–132

    Article  Google Scholar 

  4. Gianetta E, Cuneo S, Vitale B, Camerini G, Marini P, Stella M (2000) Anterior tension-free repair of recurrent hernia under local anesthesia: a 7-year experience in a teaching hospital. Ann Surg 1: 132–136

    Article  Google Scholar 

  5. Johansson B, Hallerback B, Glise H, Anesten B, Smedberg S, Roman J (1999) Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg 2: 225–231

    Article  CAS  Google Scholar 

  6. Stoker DL, Spiegelhalter DJ, Singh R, Wellwood JM (1994) Laparoscopic versus open inguinal hernia repair: randomized prospective trial. Lancet 8908: 1243–1245

    Article  Google Scholar 

  7. Heikkinen TJ, Haukipuro K, Hulkko A (1998) A cost and outcome comparison between laparoscopic and Lichtenstein hernia operations in a day-case unit: a randomized prospective study. Surg Endosc 10: 1199–1203

    Article  Google Scholar 

  8. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 12: 1479–1492

    Article  Google Scholar 

  9. Liem MS, van Duyn EB, van der Graaf Y, van Vroonhoven TJ, Coala Trial Group (2003) Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Ann Surg 1: 136–141

    Article  Google Scholar 

  10. Sayad P, Abdo Z, Cacchione R, Ferzli G (2000) Incidence of incipient contralateral hernia during laparoscopic hernia repair. Surg Endosc 6: 543–545

    Article  Google Scholar 

  11. Geis WP, Crafton WB, Novak MJ, Malago M (1993) Laparoscopic herniorrhaphy: results and technical aspects in 450 consecutive procedures. Surgery 4: 765–772

    Google Scholar 

  12. Lichenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hemioplasty. Am J Surg 2: 188–193

    Article  Google Scholar 

  13. Amid PK, Shulman AG, Lichtenstein IL (1996) Open “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 6: 447–453

    Google Scholar 

  14. Ridings P, Evans DS (2000) The transabdominal preperitoneal (TAPP) inguinal hernia repair: a trip along the learning curve. J R Coll Surg Edinb 1: 29–32

    Google Scholar 

  15. Kieturakis MJ, Nguyen DT, Vargas H, Fogarty TJ, Klein SR (1994) Balloon dissection facilitated laparoscopic extraperitoneal hernioplasty. Am J Surg 6: 603–608

    Article  Google Scholar 

  16. Ger R (1991) Laparoscopic hernia operation. Chirurg 4: 266–270

    Google Scholar 

  17. Collaboration EH (2000) Mesh compared with nonmesh methods of open groin hernia repair: systemic review of randomized controlled trials. Br J Surg 7: 854–859

    Article  Google Scholar 

  18. Beets GL, van Geldere D, Baeten CG, Go PM (1996) Long-term results of giant prosthetic reinforcement of the visceral sac for complex recurrent inguinal hernias. Br J Surg 2: 203–206

    Article  Google Scholar 

  19. Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 5: 545–554

    Article  Google Scholar 

  20. Gilbert AI, Felton LL (1993) Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 2: 126–130

    Google Scholar 

  21. Ferzli GS, Frezza EE, Pecoraro AM Jr, Ahem KD (1999) Prospective randomized study of stapled versus unstapled mesh in laparoscopic preperitoneal inguinal hernia repair. J Am Coll Surg 5: 461–465

    Article  Google Scholar 

  22. Smith AI, Royston CM, Sedman PC (1999) Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair: a prospective randomized trial. Surg Endosc 8: 804–806

    Article  Google Scholar 

  23. Feliu X, Jaurrieta E, Vinas X, Macarulla E, Abad JM, Fernandez-Sallent E (2004) Recurrent inguinal hernia: a ten-year review. J Laparoendosc Adv Surg Tech A 6: 362–367

    Google Scholar 

  24. Krahenbuhl L, Schafer M, Schilling M, Kuzinkovas V, Buchler MW (1998) Simultaneous repair of bilateral groin hernias: open or laparoscopic approach? Surg Laparosc Endosc 4: 313–318

    Article  Google Scholar 

  25. Geis WP, Malago M (1994) Laparoscopic bilateral inguinal herniorrhaphies: use of a single giant preperitoneal mesh patch. Am Surg 8: 558–563

    Google Scholar 

  26. Nordestgaard AG, Bodily KC, Osborne RW Jr, Buttorff JD (1995) Major vascular injuries during laparoscopic procedures. Am J Surg 5: 543–545

    Article  Google Scholar 

  27. Kraus MA (1993) Nerve injury during laparoscopic inguinal hernia repair. Surg Laparosc Endosc 4: 342–345

    Google Scholar 

  28. Paganini AM, Lezoche E, Carle F, Carlei F, Favretti F, Feliciotti F, Gesuita R, Guerrieri M, Lomanto D, Nardovino M, Panti M, Ribichini P, Sarli L, Sottili M, Tamburini A, Taschieri A (1998) A randomized, controlled, clinical study of laparoscopic versus open tension-free inguinal hernia repair. Surg Endosc 7: 979–986

    Article  Google Scholar 

  29. Liem MS, van der Graaf Y, van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS, Stassen LP, Vente JP, Weidema WF, Schrijvers AJ, van Vroonhoven TJ (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med 22: 1541–1547

    Article  Google Scholar 

  30. Collaboration EH (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials (review). Br J Surg 7: 860–867

    Article  Google Scholar 

  31. Chung RS, Rowland DY (1999) Meta-analyses of randomized controlled trials of laparoscopic vs conventional inguinal hernia repairs. Surg Endosc 7: 689–694

    Article  Google Scholar 

  32. Cheek CM, Black NA, Devlin HB, Kingsnorth AN, Taylor RS, Watkin DF (1998) Groin hernia surgery: a systematic review. Ann R Coll Surg Engl 80(Suppl 1): S1–8O

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 2 nd Surgical Department, Korgialenio-Benakio Red Cross Hospital, Erythrou Staruou 1, Athens, Greece

    G. Dedemadi, G. Sgourakis, C. Karaliotas, T. Christofides & C. Karaliotas

  2. 2 nd Surgical Department, University of Athens, Agiou Thoma 17, Athens, Greece

    G. Kouraklis

Authors
  1. G. Dedemadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Sgourakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Karaliotas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Christofides
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Kouraklis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Karaliotas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Dedemadi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dedemadi, G., Sgourakis, G., Karaliotas, C. et al. Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias: a prospective randomized study. Surg Endosc 20, 1099–1104 (2006). https://doi.org/10.1007/s00464-005-0621-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-005-0621-8

Keywords

Search

Navigation