Comparison of Transabdominal Preperitoneal (TAPP) and Lichtenstein Techniques for Inguinal Hernia Repair: A Prospective Study.

Abstract

Background Worldwide, inguinal hernia repair is one of the commonest surgeries. The best treatment option for primary hernia has been investigated, but there still remains a lack of evidence about the ideal approach.  Therefore, this study aimed to compare the outcomes of inguinal hernia repair using the transabdominal preperitoneal (TAPP) procedure and Lichtenstein techniques. Methods This prospective cohort study was conducted at the Department of General Surgery of Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College in Kanpur, India. For performing the analysis, we used IBM SPSS Statistics for Windows, V. 25.0 (IBM Corp., Armonk, NY, USA). Continuous variables were expressed as means and standard deviations, and the categorical ones were presented as frequencies and percentages. Results A total of 60 patients were included (30 in each group). The mean age of the patients in both groups was around 52 years, and most of the patients were males. TAPP had a longer operative time (70.6 ± 10.2 minutes) than Lichtenstein (45.2 ± 8.5 minutes). Immediate postoperative pain was higher with TAPP, but pain scores were significantly lower at the three-month follow-up with a reduced need for analgesics.  The findings suggest a lower risk of surgical site infection (SSI) with TAPP; however, the difference was not statistically significant (p = 0.304). Seroma formation was more frequent with TAPP but was self-limiting.  TAPP was linked to shorter hospital stays and faster recovery, but Lichtenstein was more cost-effective due to lower equipment costs and the use of local anesthesia. Recurrence rates were 3.3% in the Lichtenstein group, with none in the TAPP group during the six-month follow-up. Conclusion TAPP and Lichtenstein techniques are both safe and reliable techniques for inguinal hernia repair. However, TAPP repair showed lesser postoperative pain, earlier discharge from the hospital, earlier return to usual activities, better cosmetic outcomes, and less persisting pain. However, there was no significant difference in the complication rate, and TAPP repair was more costly for the patient.