A One Year Randomized Control Study To Compare Post Operative Pain In Lichtenstein Tension Free Hernia Repair Versus Laparoscopic Inguinal Hernia Repair” At A Tertiary Hospital

Abstract

BACKGROUND AND OBJECTIVES -- Inguinal hernia is a common disease condition requiring surgical procedure. Many techniques have evolved over past few decades from herniorraphy to the present day hernioplasty which is done both in open and in laparoscopic methods either TAPP or TEP. Many cases of recurrences of inguinal hernia were reported with the conventional hernioplasty. Hence newer concept of tension free meshplasty came into action. The present study is aimed to compare the post-operative pain scores between Lichtenstein tension free repair versus laparoscopic repair of inguinal hernias in patients along with evaluation of postoperative complications, hospital stay and time to return to normal activities. MATERIALS AND METHODS – A one year randomized control trial was done between January 2018 and December 2018. Patients who had inguinal hernia, satisfying the inclusion criteria and willing to participate in the study were included in this study. Group A had 20 patients who underwent Lichtenstein tension free hernia repair and Group B had 20 patients who underwent laparoscopic inguinal hernia repair. Pain scores in both groups was calculated with visual analogue scale at different time intervals. Also hospital stay in number of days, time to resume normal activities post surgery and post operative complications were recorded if any and assessment done. RESULTS – In our study we found that the VAS score was less in laparoscopic group when compared to open group measured at 24 hrs, 72 hrs and 1 week post surgery and it was showing a significant difference (p<0.0001) between the groups. There was also a significant difference found in median of time that is required for normal activity and it was significantly more in open surgery group as compared to laparoscopic group (p<0.0001). The median of hospital stay in open group is significantly more (4.35±1.81) than laparoscopic group (2.8±0.89). Even the complications were found more in open group (10%) than in laparoscopic group (5%). INTERPRETATION AND CONCLUSION – Apart from the complications, which were found to be similar, laparoscopic hernia repair was found to be more suitable, safe and efficient in all the above mentioned aspects except when there is contraindication for general anesthesia. However, the data is insufficient to conclude which surgery is better overall, as long-term follow up and large population sample are required to evaluate for chronic pain, recurrence and learning curve in laparoscopic hernia repair.