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[ Hernia Repair - Open Surgery Versus Minimally Invasive Techniques Compared ]

Hernia Repair - Open Surgery Versus Minimally Invasive Techniques Compared


A study published in the March issue of Archives of Surgery, one of the JAMA/Archives journals reveals that total extraperitoneal inguinal hernioplasty (TEP), a minimally invasive surgery for hernia repair, is linked to lower damage of inguinal (groin) sensation, higher patient satisfaction, as well as less chronic pain than open Lichtenstein repair.
Although hypoesthesia (reduced sensitivity) and chronic pain are measured following inguinal hernia repair, there have been insufficient studies conducted that compare TEP with Lichtenstein repair.
Hasan H. Eker, M.D., of Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues enrolled 660 individuals to participate in the prospective multi-center randomized clinical trial. The researchers randomly assigned 336 participants to receive TEP and 324 participants to received Lichtenstein repair. At the time of enrollment, the average (mean) age of participants was 55 years old. They received follow-up visits at 1 year and 5 years after surgery.
The researchers explained:
"Postoperative pain in the short term and chronic pain at five years after surgery were significantly greater after Lichtenstein repair vs TEP (32 percent vs 23 percent and 28 percent vs 15 percent, respectively), as was impairment of inguinal sensibility (22 percent vs 1 percent.
Patients are more satisfied after TEP with the surgical procedure and with their operative scars. Therefore, TEP should be recommended in experienced hands."

According to the researchers, hernia recurrence following inguinal hernia repair was linked to the experience level of the surgeon. Results from the study revealed that the overall incidences of hernia recurrence following TEP and Lichtenstein repair were similar at 5 years after surgery. However, among surgeons who had performed over 25 procedures, the researchers found that these rates were "significantly lower" after TEP.
The authors note that although TEP is associated with positive outcomes, it is also associated with a considerably higher incidence of complications during surgery.
The researchers conclude:
"However, none of these operative complications affected the long-term outcome of patients."

Written by Grace Rattue
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