Posterior approaches in groin hernia repair with prosthesis: open or closed

Abstract

Laparoscopic herniorraphies have been used to reduce the pain and convalescence associated with open approaches. However, there is still not any consensus of the best approach. We compared open preperitoneal and laparoscopic total extraperitoneal approaches in groin hernia repair.

Methods: Thirty-two patients underwent open preperitoneal herniorraphy (Group I) and other 32 patients underwent total extraperitoneal repair (Group II). Time of surgery was noted. Visual Analogue Scale (VAS) was applied to evaluate the postoperative pain intensity.

Results: Operation time was 35 (20-65) minutes in Group I and 58 (40-85) minutes in Group II (p < 0.05). The difference of complication ratios between two groups was not significant. Laparoscopic approach was associated with less pain within postoperative 24 hours as compared to the open technique. However, after the first postoperative day, there was no longer statistically significant difference between both groups. No recurrence has yet been seen in follow-up period of 15 (4-24) months.

Conclusion: Laparoscopic herniorraphy is associated with better results in term of postoperative pain within the first 24 hours as compared to open technique.