The analysis of the effects of laparoscopic total extraperitoneal (TEP) and Liechtenstein surgery on the long-term quality of life in the treatment of inguinal hernia
Abstract
Approximately 27-43% of men and 3-6% of women suffer from inguinal hernia during their lives. Surgery is the only viable treatment for inguinal hernia. As such, more than 20 million people worldwide are operated for inguinal hernia annually. Treatment indications and surgical procedures for inguinal hernia repair have always been discussed from a medical point of view. Along with the development of minimally invasive techniques, laparoscopic methods are frequently used in inguinal hernia surgery. In this study, we aimed to evaluate how both open and laparoscopic tension-free mesh repair methods, both of which are widely used, affect the quality of life in the long-term post-operative period.
This study was designed as a retrospective survey. Short Form-36 (SF-36) questionnaire was used as a postoperative quality of life (QoL) assessment scale. 69 (67.6%) of them underwent open surgery, while 33 (32.4%) of them underwent laparoscopic TEP. The demographic data, complications, SF-36 scale and chronic pain were evaluated, and no significant differences were found between the two groups.
In conclusion, our study compared laparoscopic and open methods and observed no significant differences between the long-term results in two different groups.
References
- 1. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362(9395):1561–71.
- 2. Fitzgibbons Jr RJ, Ramanan B, Arya S, Turner SA, Li X, Gibbs JO, et al. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg. 2013;258(3):508–15.
- 3. International guidelines for groin hernia management. Hernia. 2018;22:1–165.
- 4. Schmedt CG, Sauerland S, Bittner R. Compari-son of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc Other Interv Tech. 2005;19:188–99.
- 5. Xi S, Chen Z, Lu Q, Liu C, Xu L, Lu C, et al. Comparison of laparoscopic and open inguinal hernia repair in elderly patients: the experience of two comprehensive medical centers over 10 years. Hernia. 2024;1–9.
- 6. Lee W, Chan C, Wang B. Recent advances in laparoscopic surgery. Asian J Endosc Surg. 2013;6(1):1–8.
- 7. Aiolfi A, Cavalli M, Micheletto G, Lombardo F, Bonitta G, Morlacchi A, et al. Primary inguinal hernia: systematic review and Bayesian network meta-analysis comparing open, laparoscopic transabdominal preperitoneal, totally extraperitoneal, and robotic preperitoneal repair. Hernia. 2019;23:473–84.
- 8. Heniford BT, Walters AL, Lincourt AE, No-vitsky YW, Hope WW, Kercher KW. Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg. 2008;206(4):638–44.
- 9. Nikkolo C, Lepner U. Chronic pain after open inguinal hernia repair. Postgrad Med. 2016;128(1):69–75.
- 10. Haladu N, Alabi A, Brazzelli M, Imamura M, Ahmed I, Ramsay G, et al. Open versus laparoscopic repair of inguinal hernia: an overview of systematic reviews of randomised controlled trials. Surg Endosc. 2022;36(7):4685–700.
- 11. Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B, Gockel I. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair–A systematic review and meta-analysis of randomized controlled trials. BMC Surg. 2017;17:1–10.
- 12. Lawrence K, McWhinnie D, Jenkinson C, Co-ulter A. Quality of life in patients undergoing inguinal hernia repair. Ann R Coll Surg Engl. 1997;79(1):40.
- 13. Isil RG, Avlanmis O. Effects of totally extraperitoneal and lichtenstein hernia repair on men’s sexual function and quality of life. Surg Endosc. 2020;34:1103–11.
- 14. Bhattacharya K, Bhattacharya N. Can robotic and laparoscopic inguinal hernia repair ever replace Lichtenstein repair? Hernia. 2024;1–2.
- 15. Myers E, Browne KM, Kavanagh DO, Hurley M. Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg. 2010;34:3059–64.
- 16. Campolina AG, Ciconelli RM. SF-36 and the development of new assessment tools for quality of life. Acta Reumatol Port. 2008;33(2):127–33.
- 17. Castro GRA, Zilles A, Gazzola LD, Barros RB, Sadowski JA, Guetter CR. Laparoscopic inguinal hernia repair: the long-term assessment of chronic pain and quality of life. ABCD Arq Bras Cir Dig (São Paulo). 2022;35:e1695.
İnguinal herni tedavisinde laparoskopik total ekstraperitoneal (TEP) ve Liechtenstein cerrahisinin uzun dönem yaşam kalitesine etkilerinin değerlendirilmesi
Abstract
Erkeklerin yaklaşık %27-43'ü ve kadınların %3-6'sı yaşamları boyunca kasık fıtığı sorunuyla karşı karşıya kalmaktadır. Ameliyat, kasık fıtığı için tek geçerli tedavi yöntemidir. Bu nedenle, dünya çapında her yıl 20 milyondan fazla kişi kasık fıtığı nedeniyle ameliyat edilmektedir. Kasık fıtığı onarımında tedavi endikasyonları ve cerrahi prosedürler her zaman tıbbi bir bakış açısıyla tartışılmıştır. Minimal invaziv tekniklerin gelişmesiyle birlikte, kasık fıtığı cerrahisinde laparoskopik yöntemler sıklıkla kullanılmaktadır. Bu çalışmada, yaygın olarak kullanılan açık ve laparoskopik gerilimsiz yama onarım yöntemlerinin, her ikisi de ameliyat sonrası uzun dönemde yaşam kalitesini nasıl etkilediğini değerlendirmeyi amaçladık.
Bu çalışma retrospektif bir anket olarak tasarlanmıştır. Ameliyat sonrası yaşam kalitesi değerlendirme ölçeği olarak Kısa Form-36 (SF-36) anketi kullanılmıştır. 69 (%67,6) hastaya açık cerrahi uygulanırken, 33 (%32,4) hastaya laparoskopik TEP uygulandı. Demografik veriler, komplikasyonlar, SF-36 skalası ve kronik ağrı değerlendirildi ve iki grup arasında anlamlı bir fark bulunmadı.
Sonuç olarak, çalışmamızda laparoskopik ve açık yöntemler karşılaştırılmış ve iki farklı grupta uzun dönem sonuçlar arasında anlamlı bir fark gözlenmemiştir.
Ethical Statement
Kahramanmaraş Sütçü İmam Üniversitesi (KSÜ) Lokal Etik Değerlendirme Kurulu tarafından etik kurul onayı alınmıştır. (Tarih:05.04.2024, Oturum: 2024/03 , Karar no:04)
Supporting Institution
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi
References
- 1. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362(9395):1561–71.
- 2. Fitzgibbons Jr RJ, Ramanan B, Arya S, Turner SA, Li X, Gibbs JO, et al. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg. 2013;258(3):508–15.
- 3. International guidelines for groin hernia management. Hernia. 2018;22:1–165.
- 4. Schmedt CG, Sauerland S, Bittner R. Compari-son of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc Other Interv Tech. 2005;19:188–99.
- 5. Xi S, Chen Z, Lu Q, Liu C, Xu L, Lu C, et al. Comparison of laparoscopic and open inguinal hernia repair in elderly patients: the experience of two comprehensive medical centers over 10 years. Hernia. 2024;1–9.
- 6. Lee W, Chan C, Wang B. Recent advances in laparoscopic surgery. Asian J Endosc Surg. 2013;6(1):1–8.
- 7. Aiolfi A, Cavalli M, Micheletto G, Lombardo F, Bonitta G, Morlacchi A, et al. Primary inguinal hernia: systematic review and Bayesian network meta-analysis comparing open, laparoscopic transabdominal preperitoneal, totally extraperitoneal, and robotic preperitoneal repair. Hernia. 2019;23:473–84.
- 8. Heniford BT, Walters AL, Lincourt AE, No-vitsky YW, Hope WW, Kercher KW. Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg. 2008;206(4):638–44.
- 9. Nikkolo C, Lepner U. Chronic pain after open inguinal hernia repair. Postgrad Med. 2016;128(1):69–75.
- 10. Haladu N, Alabi A, Brazzelli M, Imamura M, Ahmed I, Ramsay G, et al. Open versus laparoscopic repair of inguinal hernia: an overview of systematic reviews of randomised controlled trials. Surg Endosc. 2022;36(7):4685–700.
- 11. Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B, Gockel I. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair–A systematic review and meta-analysis of randomized controlled trials. BMC Surg. 2017;17:1–10.
- 12. Lawrence K, McWhinnie D, Jenkinson C, Co-ulter A. Quality of life in patients undergoing inguinal hernia repair. Ann R Coll Surg Engl. 1997;79(1):40.
- 13. Isil RG, Avlanmis O. Effects of totally extraperitoneal and lichtenstein hernia repair on men’s sexual function and quality of life. Surg Endosc. 2020;34:1103–11.
- 14. Bhattacharya K, Bhattacharya N. Can robotic and laparoscopic inguinal hernia repair ever replace Lichtenstein repair? Hernia. 2024;1–2.
- 15. Myers E, Browne KM, Kavanagh DO, Hurley M. Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg. 2010;34:3059–64.
- 16. Campolina AG, Ciconelli RM. SF-36 and the development of new assessment tools for quality of life. Acta Reumatol Port. 2008;33(2):127–33.
- 17. Castro GRA, Zilles A, Gazzola LD, Barros RB, Sadowski JA, Guetter CR. Laparoscopic inguinal hernia repair: the long-term assessment of chronic pain and quality of life. ABCD Arq Bras Cir Dig (São Paulo). 2022;35:e1695.
Details
| Primary Language | English |
|---|---|
| Subjects | General Surgery |
| Journal Section | Research Article |
| Authors | |
| Submission Date | June 23, 2025 |
| Acceptance Date | September 27, 2025 |
| Publication Date | February 10, 2026 |
| Published in Issue | Year 2026 Issue: 19 |
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The aim of the Journal of Surgical Arts (Cerrahi Sanatlar Dergisi) is to publish high-quality research articles, review articles on current topics, and rare case reports in the field of surgery. Additionally, expert opinions, letters to the editor, scientific letters, and manuscripts on surgical techniques are accepted for publication, and various manuscripts on medicine and surgery history, ethics, surgical education, and forensic medicine fields are included in the journal.
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The aim of the Journal of Surgical Arts (Cerrahi Sanatlar Dergisi) is to publish high-quality research articles, review articles on current topics, and rare case reports in the field of surgery. Additionally, expert opinions, letters to the editor, scientific letters, and manuscripts on surgical techniques are accepted for publication, and various manuscripts on medicine and surgery history, ethics, surgical education, and forensic medicine fields are included in the journal.
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Baş Editör
Hepatopankreatobiliyer cerrahi, Bariatrik cerrahi ve Laparoskopik cerrahi
Alan Editörü
Gastroenterolojik cerrahi, Kolorektal cerrahi ve Bariatrik cerrahi
Hepatopankreatobiliyer cerrahi ve Transplantasyon
Genel Cerrahi, Hepatopankreatobiliyer cerrahi ve Transplantasyon
Hepatopankreatobiliyer cerrahi, Kolorektal cerrahi ve Acil karın cerrahisi
Plastik ve Rekonstrüktif Cerrahi
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