Prospective Comparitive study between Laparoscopic Hernioplasty and Open Hernioplasty

Abstract

The mean age group of patients operated was 41 ± 3.5 in the Laparoscopic group and 42 ± 3.3 in the Open group. The operating time of most of the open cases was within 45-90 minutes while in the Laparoscopic group it was 75-120 minutes. Operating time was found higher in the Laparoscopic group than in the Open group. Learning curve was 42 patients in the Laparoscopic group and 5 patients in the Open group. Post operative pain was found lesser in the Laparoscopic group in comparison to the Open group. The pain was less in the Laparoscopic group but gradually decreased by the second week in the Open group. Patients in both groups became equal to all pain assessments during the third month follow-up. Laparoscopic repair produced less tissue trauma than open repair and therefore there was less acute phase inflammatory response leading onto less pain and earlier recovery in the Lap group in comparison to the Open group. The average hospital stay was about 1.5-2 days in the Laparoscopic group and 2-4 days in the Open group. Ability to perform day to day activities was found to be earlier in Laparoscopic repair than in Open repair 2-3 days in Lap repair and 5-8 days in Open repair. Returning to work was earlier with patients in the Laparoscopic group than those in the Open group. Patients in the Laparoscopic group resumed work on the 12th day whereas patients in the Open group resumed work on the 16th day. The final word on hernia will probably never be written. In collecting, assimilating and distilling the wisdom of today we must provide a base from which further advances may be made. -- Sir John Bruce -- The study clearly favours Laparoscpic Totally Extraperitoneal Repair over Open Repair with regards to post operative pain, resumption of routine physical activities and return to work. The frequency of chronic pain was found to be slightly lower in the Laparoscopic Totally Extraperitoneal Repair in comparison to Lichtenstein Repair in this study.