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    • Comparative Study between Open and Trans-abdominal Pre-peritoneal Repair of Inguinal Hernia

    Mohammad Ahmad Abdel Gawad, Osama Ahmed Radwan, Ahmed Abdel Aal, Mohamed Gamal Eldin
    Department of Surgery, Faculty of Medicine, Al-Azhar University General and Laparoscopic Surgery Department, Al Maadi Armed Forces Hospitals

    Background: Inguinal hernia repair is one of the most widely performed surgical procedures. Amongst the techniques used, the open Lichtenstein repair (OLR) which still the most widely performed. However, in the last decade there has been an increased interest in the laparoscopic approach for inguinal hernia repair, mainly the trans-abdominal pre-peritoneal (TAPP) technique. As described in recent studies, TAPP approach entails the benefits of minimally invasive surgery, such as less pain and early recovery. Objective: To compare open Lichtenstein repair of inguinal hernia and laparoscopic trans-abdominal preperitoneal repair of inguinal hernia (TAPP) regarding intraoperative, postoperative complications and hospital stay. Patients and Methods: This Prospective study included 40 male patients from Al Maadi Armed Forces Hospitals and General Surgery Department of Al-Azhar University Hospitals. All patients were suffering from oblique inguinal hernia with an age ranged between 21 and 66 years with otherwise good health. They were divided into 2 groups: Group A comprised 20 patients who underwent laparoscopic trans-abdominal pre-peritoneal repair (TAPP) and group B comprised 20 patients who underwent open Lichtenstein repair. Results: Our study showed that the operative time was significantly longer in TAPP group compared to the open group (97.5 ± 19.9 min versus 70.3 ± 19.5 with P value 0.001). No difference was detected in intraoperative complication between the two groups. There was significant less postoperative pain from day 1 to day 7 in TAPP group compared to the open group (P value = 0.0001). Postoperative stay was similar as all patients were discharged 24 hours postoperative. As regards postoperative complications, wound infection was recorded in 1 patient in each group, hematoma in one patient and seroma in two patients in open group but neither hematoma nor sreoma recorded in the TAPP group. Conclusion: Our study showed that laparoscopic TAPP approach for inguinal hernia repair is safe and reduces early post-operative pain. Furthermore, it is related to less postoperative complications, although it takes a longer operative time. Keywords: Trans-abdominal, pre-peritoneal, hematoma, seroma. 

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