Bassini repair compared with laparoscopic repair for primary inguinal hernia: a randomised controlled trial

Abstract

Objective: To compare the effectiveness of open and laparoscopic primary inguinal hernia repair.

Design: Randomised controlled trial.

Setting: University hospital, The Netherlands.

Subjects: 87 patients had 103 open repairs and 88 patients had 114 laparoscopic repairs between November 1993 and July 1995.

Interventions: Laparoscopic repair by the transabdominal preperitoneal (TAPP) technique and open repair by the Bassini technique.

Main outcome measures: Recurrence, morbidity, pain, and duration of convalescence.

Results: Operating time was longer for laparoscopy (mean (SD): 82 (28) compared with 45 (15) minutes p < 0.001). Patients in the Bassini group had higher postoperative pain scores (mean (SD)VAS: 2.9 (1.6) compared with 2.0 (1.6) p=0.002), used more analgesics (median total intake: 2 (0-54) compared with 0 tablets (0-42) p=0.008), and needed a longer convalescence time (mean (SD) time to return to work: 22 (12.6) compared with 14 (10.1) days p < 0.001; mean (SD) time to return to physical activities: 27 (12.6) compared with 17 (12.2) days p < 0.001). Mean follow up was 24 months. Recurrence rates were 21% (22/ 103) after Bassini and 6% (7/114) after laparoscopic repair (p=0.001).

Conclusion: Laparoscopic hernia repair is a safe operation, which has obvious advantages over the Bassini repair in terms of pain, use of analgesic drugs, resumption of activities, and recurrence. A disadvantage of the laparoscopic repair is the longer operating time.