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Year 2025, Volume: 11 Issue: 5, 878 - 884, 04.09.2025
https://doi.org/10.18621/eurj.1729441

Abstract

References

  • 1. Tigora A, Radu PA, Garofil DN, et al. Modern Perspectives on Inguinal Hernia Repair: A Narrative Review on Surgical Techniques, Mesh Selection and Fixation Strategies. J Clin Med. 2025 9;14(14):4875. doi: 10.3390/jcm14144875.
  • 2. Some Remarks on Hernia: III. Bassini's Operation for Radical Cure of an Inguinal Hernia. Hospital (Lond 1886). 1908 Oct 24;45(1157):91.
  • 3. Messaris E, Nicastri G, Dudrick SJ. Total extraperitoneal laparoscopic inguinal hernia repair without mesh fixation: prospective study with 1-year follow-up results. Arch Surg. 2010;145(4):334-338. doi: 10.1001/archsurg.2010.20.
  • 4. Messenger DE, Aroori S, Vipond MN. Five-year prospective follow-up of 430 laparoscopic totally extraperitoneal inguinal hernia repairs in 275 patients. Ann R Coll Surg Engl. 2010;92(3):201-205. doi: 10.1308/003588410X12628812458455.
  • 5. Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB. Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified Lichtenstein repairs. Ann Surg. 2011;254(5):709-714; discussion 714-5. doi: 10.1097/SLA.0b013e3182359d07.
  • 6. Ger R. The management of certain abdominal herniae by intra-abdominal closure of the neck of the sac. Preliminary communication. Ann R Coll Surg Engl. 1982;64(5):342-344.
  • 7. Rosenberg J, Baig S, Chen DC, Derikx J. Groin hernia. Nat Rev Dis Primers. 2025;11(1):47. doi: 10.1038/s41572-025-00631-4.
  • 8. Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-1007. doi: 10.1097/j.pain.0000000000000160.
  • 9. Song JW, Wolf JS Jr, McGillicuddy JE, Bhangoo S, Yang LJ. Laparoscopic triple neurectomy for intractable groin pain: technical report of 3 cases. Neurosurgery. 2011;68(2 Suppl Operative):339-46; discussion 346. doi: 10.1227/NEU.0b013e3182114480.
  • 10. Lange JF, Kaufmann R, Wijsmuller AR, et al. An international consensus algorithm for management of chronic postoperative inguinal pain. Hernia. 2015;19(1):33-43. doi: 10.1007/s10029-014-1292-y.
  • 11. Voorbrood CE, Burgmans JP, Van Dalen T, et al. An algorithm for assessment and treatment of postherniorrhaphy pain. Hernia. 2015;19(4):571-577. doi: 10.1007/s10029-015-1387-0.
  • 12. Bjurstrom MF, Nicol AL, Amid PK, Chen DC. Pain control following inguinal herniorrhaphy: current perspectives. J Pain Res. 2014;7:277-290. doi: 10.2147/JPR.S47005.
  • 13. Sacaklidir R, Sanal-Toprak C, Yucel FN, Gunduz OH, Sencan S. The Effect of Central Sensitization on Interlaminar Epidural Steroid Injection Treatment Outcomes in Patients with Cervical Disc Herniation: An Observational Study. Pain Physician. 2022;25(6):E823-E829.
  • 14. Jeppesen M, Tolstrup MB, Gögenur I. Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction. World J Surg. 2016;40(9):2091-2097. doi: 10.1007/s00268-016-3616-9.
  • 15. Tetik C, Arregui ME, Dulucq JL, et al. Complications and recurrences associated with laparoscopic repair of groin hernias. A multi-institutional retrospective analysis. Surg Endosc. 1994;8(11):1316-1322; discussion 1322-3. doi: 10.1007/BF00188291.
  • 16. Varcuş F, Duta C, Dobrescu A, Lazar F, Papurica M, Tarta C. Laparoscopic Repair of Inguinal Hernia TEP versus TAPP. Chirurgia (Bucur). 2016;111(4):308-312.
  • 17. Chung SD, Huang CY, Wang SM, et al. Laparoendoscopic single-site totally extraperitoneal adult inguinal hernia repair: initial 100 patients. Surg Endosc. 2011;25(11):3579-3583. doi: 10.1007/s00464-011-1761-7.
  • 18. Choi YY, Han SW, Bae SH, Kim SY, Hur KY, Kang GH. Comparison of the outcomes between laparoscopic totally extraperitoneal repair and prolene hernia system for inguinal hernia; review of one surgeon's experience. J Korean Surg Soc. 2012;82(1):40-44. doi: 10.4174/jkss.2012.82.1.40.
  • 19. Choi YY, Kim Z, Hur KY. Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia. Can J Surg. 2012;55(1):33-36. doi: 10.1503/cjs.019610.
  • 20. Sharma D, Yadav K, Hazrah P, Borgharia S, Lal R, Thomas S. Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias. Int J Surg. 2015;22:110-117. doi: 10.1016/j.ijsu.2015.07.713.
  • 21. Bansal VK, Krishna A, Ghosh N, Bittner R, Misra MC. Comparison TAPP vs. TEP: Which Technique Is Better? In: Bittner R, Köckerling F, Fitzgibbons R Jr, LeBlanc K, Mittal S, Chowbey P (editors). Laparo-endoscopic Hernia Surgery. Springer, Berlin, Heidelberg. 2018: pp. 151-170.
  • 22. Schouten N, Elshof JW, Simmermacher RK, et al. Selecting patients during the "learning curve" of endoscopic Totally Extraperitoneal (TEP) hernia repair. Hernia. 2013;17(6):737-743. doi: 10.1007/s10029-012-1006-2.
  • 23. Matsumoto S, Hayakawa T, Kawarada Y, et al. Proper training in laparoscopic hernia repair is necessary to minimize the rising recurrence rate in Japan. Asian J Endosc Surg. 2018;11(2):151-154. doi: 10.1111/ases.12433.
  • 24. Wu JJ, Way JA, Eslick GD, Cox MR. Transabdominal Pre-Peritoneal Versus Open Repair for Primary Unilateral Inguinal Hernia: A Meta-analysis. World J Surg. 2018;42(5):1304-1311. doi: 10.1007/s00268-017-4288-9.
  • 25. Kumar M, Jha AK, Kumar D, Hasan I, Kumar D. An Observational Study on the Comparative Analysis of Trans Abdominal Preperitoneal and Totally Extraperitoneal: A Single-center Experience of 105 Patients. Ann Afr Med. 2025 Jul 23. doi: 10.4103/aam.aam_183_24.
  • 26. Sağıroğlu J, Özdemir T, Atak T, et al. Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Without Mesh Fixation: Report of Early Outcomes. South Clin Ist Euras 2016;27(3):215-219. doi: 10.14744/scie.2017.64872.
  • 27. Thölix AM, Kössi J, Grönroos-Korhonen M, Harju J. Laparoscopic inguinal hernia repair with self-fixated meshes: a randomized controlled trial. Surg Endosc. 2025;39(4):2425-2435. doi: 10.1007/s00464-025-11616-5.
  • 28. Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: A qualified systematic review. World J Methodol. 2015;5(4):238-254. doi: 10.5662/wjm.v5.i4.238.
  • 29. Doudakmanis C, Kolla C, Bouliaris K, Efthimiou M, Koukoulis GD. Laparoscopic bilateral inguinal hernia repair: Should it be the preferred technique? World J Methodol. 2022;12(4):193-199. doi: 10.5662/wjm.v12.i4.193.
  • 30. HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165. doi: 10.1007/s10029-017-1668-x.

Evaluation of postoperative chronic neuropathic pain in patients with Lichtenstein hernia repair and laparoscopic hernia repair

Year 2025, Volume: 11 Issue: 5, 878 - 884, 04.09.2025
https://doi.org/10.18621/eurj.1729441

Abstract

Objectives: The high incidence of inguinal hernia over the globe makes hernia repair the most common procedure in general surgery, and 10-15% of all surgeries are composed of hernia repair. In this study, we tried to elucidate the effect of risk factors of laparoscopic techniques on chronic neuropathic pain formation in the postoperative period in patients who underwent Lichtenstein hernia repair and laparoscopic hernia repair.

Methods: A total of 404 patients have been enrolled in this study. Two different surgery techniques have been conducted on the participants, as Lichtenstein repair (n=214) and laparoscopic inguinal hernia repair (n=190). Demographic data of the patients were recorded. Transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques were applied to patients who underwent laparoscopic repair. The 'Lanss Pain Score' was utilized in the evaluation of chronic pain in the postoperative period.

Results: We detected a statistically significant difference between the groups in terms of age and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores (P<0.05). It was determined that the mean age of the patients with Lichtenstein repair was 57, and the mean LANSS score was 3. It was determined that the mean age of the patients with laparoscopic inguinal hernia repair was 49, and the mean LANSS score was 1. The distribution of demographic and clinical findings of the patients who underwent laparoscopic inguinal hernia repair according to the operation methods revealed no statistically significant difference in patients who underwent TAPP and TEP methods.

Conclusions: In conclusion, the TEP and TAPP methods have lower pain in the postoperative period.

Ethical Statement

This study was approved by the Bursa Yüksek Ihtisas Training and Reserach Hospital Clinical Research Ethics Committee (Decision No: 2011-KAEK-25 2021/12-22; date: 29.12.2021). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Written informed consent was obtained from all individual participants included in the study.

References

  • 1. Tigora A, Radu PA, Garofil DN, et al. Modern Perspectives on Inguinal Hernia Repair: A Narrative Review on Surgical Techniques, Mesh Selection and Fixation Strategies. J Clin Med. 2025 9;14(14):4875. doi: 10.3390/jcm14144875.
  • 2. Some Remarks on Hernia: III. Bassini's Operation for Radical Cure of an Inguinal Hernia. Hospital (Lond 1886). 1908 Oct 24;45(1157):91.
  • 3. Messaris E, Nicastri G, Dudrick SJ. Total extraperitoneal laparoscopic inguinal hernia repair without mesh fixation: prospective study with 1-year follow-up results. Arch Surg. 2010;145(4):334-338. doi: 10.1001/archsurg.2010.20.
  • 4. Messenger DE, Aroori S, Vipond MN. Five-year prospective follow-up of 430 laparoscopic totally extraperitoneal inguinal hernia repairs in 275 patients. Ann R Coll Surg Engl. 2010;92(3):201-205. doi: 10.1308/003588410X12628812458455.
  • 5. Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB. Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified Lichtenstein repairs. Ann Surg. 2011;254(5):709-714; discussion 714-5. doi: 10.1097/SLA.0b013e3182359d07.
  • 6. Ger R. The management of certain abdominal herniae by intra-abdominal closure of the neck of the sac. Preliminary communication. Ann R Coll Surg Engl. 1982;64(5):342-344.
  • 7. Rosenberg J, Baig S, Chen DC, Derikx J. Groin hernia. Nat Rev Dis Primers. 2025;11(1):47. doi: 10.1038/s41572-025-00631-4.
  • 8. Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-1007. doi: 10.1097/j.pain.0000000000000160.
  • 9. Song JW, Wolf JS Jr, McGillicuddy JE, Bhangoo S, Yang LJ. Laparoscopic triple neurectomy for intractable groin pain: technical report of 3 cases. Neurosurgery. 2011;68(2 Suppl Operative):339-46; discussion 346. doi: 10.1227/NEU.0b013e3182114480.
  • 10. Lange JF, Kaufmann R, Wijsmuller AR, et al. An international consensus algorithm for management of chronic postoperative inguinal pain. Hernia. 2015;19(1):33-43. doi: 10.1007/s10029-014-1292-y.
  • 11. Voorbrood CE, Burgmans JP, Van Dalen T, et al. An algorithm for assessment and treatment of postherniorrhaphy pain. Hernia. 2015;19(4):571-577. doi: 10.1007/s10029-015-1387-0.
  • 12. Bjurstrom MF, Nicol AL, Amid PK, Chen DC. Pain control following inguinal herniorrhaphy: current perspectives. J Pain Res. 2014;7:277-290. doi: 10.2147/JPR.S47005.
  • 13. Sacaklidir R, Sanal-Toprak C, Yucel FN, Gunduz OH, Sencan S. The Effect of Central Sensitization on Interlaminar Epidural Steroid Injection Treatment Outcomes in Patients with Cervical Disc Herniation: An Observational Study. Pain Physician. 2022;25(6):E823-E829.
  • 14. Jeppesen M, Tolstrup MB, Gögenur I. Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction. World J Surg. 2016;40(9):2091-2097. doi: 10.1007/s00268-016-3616-9.
  • 15. Tetik C, Arregui ME, Dulucq JL, et al. Complications and recurrences associated with laparoscopic repair of groin hernias. A multi-institutional retrospective analysis. Surg Endosc. 1994;8(11):1316-1322; discussion 1322-3. doi: 10.1007/BF00188291.
  • 16. Varcuş F, Duta C, Dobrescu A, Lazar F, Papurica M, Tarta C. Laparoscopic Repair of Inguinal Hernia TEP versus TAPP. Chirurgia (Bucur). 2016;111(4):308-312.
  • 17. Chung SD, Huang CY, Wang SM, et al. Laparoendoscopic single-site totally extraperitoneal adult inguinal hernia repair: initial 100 patients. Surg Endosc. 2011;25(11):3579-3583. doi: 10.1007/s00464-011-1761-7.
  • 18. Choi YY, Han SW, Bae SH, Kim SY, Hur KY, Kang GH. Comparison of the outcomes between laparoscopic totally extraperitoneal repair and prolene hernia system for inguinal hernia; review of one surgeon's experience. J Korean Surg Soc. 2012;82(1):40-44. doi: 10.4174/jkss.2012.82.1.40.
  • 19. Choi YY, Kim Z, Hur KY. Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia. Can J Surg. 2012;55(1):33-36. doi: 10.1503/cjs.019610.
  • 20. Sharma D, Yadav K, Hazrah P, Borgharia S, Lal R, Thomas S. Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias. Int J Surg. 2015;22:110-117. doi: 10.1016/j.ijsu.2015.07.713.
  • 21. Bansal VK, Krishna A, Ghosh N, Bittner R, Misra MC. Comparison TAPP vs. TEP: Which Technique Is Better? In: Bittner R, Köckerling F, Fitzgibbons R Jr, LeBlanc K, Mittal S, Chowbey P (editors). Laparo-endoscopic Hernia Surgery. Springer, Berlin, Heidelberg. 2018: pp. 151-170.
  • 22. Schouten N, Elshof JW, Simmermacher RK, et al. Selecting patients during the "learning curve" of endoscopic Totally Extraperitoneal (TEP) hernia repair. Hernia. 2013;17(6):737-743. doi: 10.1007/s10029-012-1006-2.
  • 23. Matsumoto S, Hayakawa T, Kawarada Y, et al. Proper training in laparoscopic hernia repair is necessary to minimize the rising recurrence rate in Japan. Asian J Endosc Surg. 2018;11(2):151-154. doi: 10.1111/ases.12433.
  • 24. Wu JJ, Way JA, Eslick GD, Cox MR. Transabdominal Pre-Peritoneal Versus Open Repair for Primary Unilateral Inguinal Hernia: A Meta-analysis. World J Surg. 2018;42(5):1304-1311. doi: 10.1007/s00268-017-4288-9.
  • 25. Kumar M, Jha AK, Kumar D, Hasan I, Kumar D. An Observational Study on the Comparative Analysis of Trans Abdominal Preperitoneal and Totally Extraperitoneal: A Single-center Experience of 105 Patients. Ann Afr Med. 2025 Jul 23. doi: 10.4103/aam.aam_183_24.
  • 26. Sağıroğlu J, Özdemir T, Atak T, et al. Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Without Mesh Fixation: Report of Early Outcomes. South Clin Ist Euras 2016;27(3):215-219. doi: 10.14744/scie.2017.64872.
  • 27. Thölix AM, Kössi J, Grönroos-Korhonen M, Harju J. Laparoscopic inguinal hernia repair with self-fixated meshes: a randomized controlled trial. Surg Endosc. 2025;39(4):2425-2435. doi: 10.1007/s00464-025-11616-5.
  • 28. Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: A qualified systematic review. World J Methodol. 2015;5(4):238-254. doi: 10.5662/wjm.v5.i4.238.
  • 29. Doudakmanis C, Kolla C, Bouliaris K, Efthimiou M, Koukoulis GD. Laparoscopic bilateral inguinal hernia repair: Should it be the preferred technique? World J Methodol. 2022;12(4):193-199. doi: 10.5662/wjm.v12.i4.193.
  • 30. HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165. doi: 10.1007/s10029-017-1668-x.
There are 30 citations in total.

Details

Primary Language English
Subjects General Surgery
Journal Section Original Articles
Authors

Mehmet Fatih Erol 0000-0003-0501-6223

Muhammed Doğangün 0000-0002-5504-7338

Berkay Demir 0000-0002-9582-7048

Sinan Arıcı 0000-0002-7986-3874

Füsun Gözen 0000-0002-4219-7863

Early Pub Date August 22, 2025
Publication Date September 4, 2025
Submission Date June 28, 2025
Acceptance Date August 18, 2025
Published in Issue Year 2025 Volume: 11 Issue: 5

Cite

AMA Erol MF, Doğangün M, Demir B, Arıcı S, Gözen F. Evaluation of postoperative chronic neuropathic pain in patients with Lichtenstein hernia repair and laparoscopic hernia repair. Eur Res J. September 2025;11(5):878-884. doi:10.18621/eurj.1729441


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