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Year 2025, Volume: 11 Issue: 5, 1008 - 1014, 04.09.2025
https://doi.org/10.18621/eurj.1750403

Abstract

References

  • 1. Vallipriya V, Surendran S. Comparison of outcome between laparoscopic inguinal hernia repair and open inguinal hernia repair. Int Surg J. 2022;9(6):1231-1235. doi: 10.18203/2349-2902.isj20221335.
  • 2. Burton V, Perez AJ. Comparison of open and laparoscopic inguinal hernia repair. Mini-invasive Surg. 2021;5:26. doi: 10.20517/2574-1225.2021.26.
  • 3. Pulikkal Reghunandanan R, Ali Usman A, Basheer S, Kuttichi L, Els Jojo J, Abdul Rasheed MF. Laparoscopic Versus Open Inguinal Hernia Repair: A Comparative Study. Cureus, 2023;15(11):e48619. doi: 10.7759/cureus.48619.
  • 4. Bind RK, Ram B, Singh U. Direct Inguinal Hernias and Anterior Surgical Approach are risk factors for female Inguinal Hernia Recurrences. Int J Life Sci Biotechnol Pharma Res. 2024;13(9):97-101. doi: 10.69605/ijlbpr_13.9.2024.16.
  • 5. Shah MY, Raut P, Wilkinson TRV, Agrawal V. Surgical outcomes of laparoscopic total extraperitoneal (TEP) inguinal hernia repair compared with Lichtenstein tension-free open mesh inguinal hernia repair: A prospective randomized study. Medicine (Baltimore). 2022;101(26):e29746. doi: 10.1097/MD.0000000000029746.
  • 6. Zhao Y, Xu Z, Wang T, et al. The impact of laparoscopic versus open inguinal hernia repair for inguinal hernia treatment: A retrospective cohort study. Health Sci Rep. 2023;6(4):e1194. doi: 10.1002/hsr2.1194.
  • 7. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240-52. doi: 10.1002/acr.20543.
  • 8. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain, 1997;72(1-2):95-97. doi: 10.1016/s0304-3959(97)00005-5.
  • 9. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR. Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg. 2003;90(12):1479-1492. doi: 10.1002/bjs.4301.
  • 10. Gavriilidis P, Davies RJ, Wheeler J, de’Angelis N, Di Saverio S. Total extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty: a systematic review by updated traditional and cumulative meta-analysis of randomised-controlled trials. Hernia 2019;23(9):1093-1103. doi: 10. 1007/ s10029-019-02049-w.
  • 11. O A, A G, M J, H WC, Al-Kandari A, S C, M M. Is laparoscopic inguinal hernia repair more effective than open repair? J Coll Physicians Surg Pak. 2011;21(5):291-6.
  • 12. Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair. Surg Endosc. 2005;19:188-199. doi: 10.1007/s00464-004-9126-0.
  • 13. HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165. doi: 10.1007/s10029-017-1668-x.
  • 14. Haladu N, Alabi A, Brazzelli M, et al. Open versus laparoscopic repair of inguinal hernia: an overview of systematic reviews of randomised controlled trials. Surg Endosc. 2022;36(7):4685-4700. doi: 10.1007/s00464-022-09161-6.
  • 15. Patterson TJ, Beck J, Currie PJ, Spence RAJ, Spence G. Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair. Br J Surg. 2019;106(7):824-836. doi: 10.1002/bjs.11139.
  • 16. Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia. 2015;19(3):355-366. doi: 10. 1007/s10029-014-1281-1.
  • 17. Yang J, Tong da N, Yao J, Chen W. Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: a meta-analysis of randomized controlled trials. ANZ J Surg. 2013;83(5):312-318. doi: 10.1111/ans.12010.
  • 18. Ulusoy S, Özer M, Albuz Ö, Parlak Ö. Comparison of Lichtenstein and total extraperitoneal laparoscopic hernia repair (TEP) methods in inguinal hernias. Ortadogu Tıp Derg. 2019;11(4):366-371. doi: 10.21601/ortadogutipdergisi.464026.
  • 19. Hernandez-Rosa J, Lo CC, Choi JJ, et al. Laparoscopic versus open inguinal hernia repair in octogenarians. Hernia. 2011;15(6):655-658. doi: 10.1007/s10029-011-0838-5.
  • 20. Ciftci F. Laparoscopic versus open inguinal hernia repair on patients over 75 years of age Int J Clin Exp Med. 2015;8(6):10016-10020.
  • 21. Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc. 2003;17(6):850-856. doi: 10.1007/s00464-002-8575-6.

Comparison of clinical outcomes of Lichtenstein and laparoscopic totally extraperitoneal repair techniques in inguinal hernia surgery

Year 2025, Volume: 11 Issue: 5, 1008 - 1014, 04.09.2025
https://doi.org/10.18621/eurj.1750403

Abstract

Objectives: This study aims to compare the clinical outcomes of open surgery (Lichtenstein procedure) with laparoscopic surgery (Totally Extraperitoneal Repair - TEP) for inguinal hernia repair. The duration of the procedure, postoperative pain, and occurrence of complications were evaluated.

Methods: A retrospective research including 95 male patients was carried out from June 2023 to January 2025. Patients were classified into Lichtenstein (n=50) and TEP (n=45) groups. Demographic data, operational durations, postoperative pain evaluations (visual analog scale - VAS), return-to-work intervals, and complications were analyzed for comparison.

Results: The operating duration was diminished in the TEP group, with 24±3.1 minutes for unilateral patients and 37±4.2 minutes for bilateral cases, in contrast to 46±5.3 minutes and 72±8.0 minutes in the Lichtenstein group, respectively. Postoperative pain scores were significantly decreased in the TEP group at all time intervals. The recurrence rates were low in both cohorts, recorded at 2.0% for the Lichtenstein group and 2.2% for the TEP group. The complication rates were similar, with wound infection occurring in 6% and hematoma in 4% of the Lichtenstein group, whereas seroma was noted in 4.4% of the TEP group.

Conclusions: The laparoscopic TEP technique surpasses open surgery in terms of operating length and postoperative pain; yet, both methods are safe therapeutic options with low complication and recurrence rates.

Ethical Statement

This study was approved by the KTO Karatay University, School of Medicine, Non-Interventional Clinical Research Ethics Committee (Decision No: 2025/023; Date: 12.06.2025). 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. Informed consent was waived because of the retrospective nature of the study. All data were anonymized, and participant confidentiality was strictly maintained.

References

  • 1. Vallipriya V, Surendran S. Comparison of outcome between laparoscopic inguinal hernia repair and open inguinal hernia repair. Int Surg J. 2022;9(6):1231-1235. doi: 10.18203/2349-2902.isj20221335.
  • 2. Burton V, Perez AJ. Comparison of open and laparoscopic inguinal hernia repair. Mini-invasive Surg. 2021;5:26. doi: 10.20517/2574-1225.2021.26.
  • 3. Pulikkal Reghunandanan R, Ali Usman A, Basheer S, Kuttichi L, Els Jojo J, Abdul Rasheed MF. Laparoscopic Versus Open Inguinal Hernia Repair: A Comparative Study. Cureus, 2023;15(11):e48619. doi: 10.7759/cureus.48619.
  • 4. Bind RK, Ram B, Singh U. Direct Inguinal Hernias and Anterior Surgical Approach are risk factors for female Inguinal Hernia Recurrences. Int J Life Sci Biotechnol Pharma Res. 2024;13(9):97-101. doi: 10.69605/ijlbpr_13.9.2024.16.
  • 5. Shah MY, Raut P, Wilkinson TRV, Agrawal V. Surgical outcomes of laparoscopic total extraperitoneal (TEP) inguinal hernia repair compared with Lichtenstein tension-free open mesh inguinal hernia repair: A prospective randomized study. Medicine (Baltimore). 2022;101(26):e29746. doi: 10.1097/MD.0000000000029746.
  • 6. Zhao Y, Xu Z, Wang T, et al. The impact of laparoscopic versus open inguinal hernia repair for inguinal hernia treatment: A retrospective cohort study. Health Sci Rep. 2023;6(4):e1194. doi: 10.1002/hsr2.1194.
  • 7. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240-52. doi: 10.1002/acr.20543.
  • 8. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain, 1997;72(1-2):95-97. doi: 10.1016/s0304-3959(97)00005-5.
  • 9. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR. Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg. 2003;90(12):1479-1492. doi: 10.1002/bjs.4301.
  • 10. Gavriilidis P, Davies RJ, Wheeler J, de’Angelis N, Di Saverio S. Total extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty: a systematic review by updated traditional and cumulative meta-analysis of randomised-controlled trials. Hernia 2019;23(9):1093-1103. doi: 10. 1007/ s10029-019-02049-w.
  • 11. O A, A G, M J, H WC, Al-Kandari A, S C, M M. Is laparoscopic inguinal hernia repair more effective than open repair? J Coll Physicians Surg Pak. 2011;21(5):291-6.
  • 12. Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair. Surg Endosc. 2005;19:188-199. doi: 10.1007/s00464-004-9126-0.
  • 13. HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165. doi: 10.1007/s10029-017-1668-x.
  • 14. Haladu N, Alabi A, Brazzelli M, et al. Open versus laparoscopic repair of inguinal hernia: an overview of systematic reviews of randomised controlled trials. Surg Endosc. 2022;36(7):4685-4700. doi: 10.1007/s00464-022-09161-6.
  • 15. Patterson TJ, Beck J, Currie PJ, Spence RAJ, Spence G. Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair. Br J Surg. 2019;106(7):824-836. doi: 10.1002/bjs.11139.
  • 16. Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia. 2015;19(3):355-366. doi: 10. 1007/s10029-014-1281-1.
  • 17. Yang J, Tong da N, Yao J, Chen W. Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: a meta-analysis of randomized controlled trials. ANZ J Surg. 2013;83(5):312-318. doi: 10.1111/ans.12010.
  • 18. Ulusoy S, Özer M, Albuz Ö, Parlak Ö. Comparison of Lichtenstein and total extraperitoneal laparoscopic hernia repair (TEP) methods in inguinal hernias. Ortadogu Tıp Derg. 2019;11(4):366-371. doi: 10.21601/ortadogutipdergisi.464026.
  • 19. Hernandez-Rosa J, Lo CC, Choi JJ, et al. Laparoscopic versus open inguinal hernia repair in octogenarians. Hernia. 2011;15(6):655-658. doi: 10.1007/s10029-011-0838-5.
  • 20. Ciftci F. Laparoscopic versus open inguinal hernia repair on patients over 75 years of age Int J Clin Exp Med. 2015;8(6):10016-10020.
  • 21. Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc. 2003;17(6):850-856. doi: 10.1007/s00464-002-8575-6.
There are 21 citations in total.

Details

Primary Language English
Subjects General Surgery
Journal Section Original Articles
Authors

Ramazan Saygın Kerimoğlu 0000-0003-3149-9636

Süleyman Kargın 0000-0003-4597-8654

Abdullah Sami Maden 0000-0001-7761-7074

Abdullah Gürhan Duyan 0000-0003-2571-976X

Early Pub Date September 1, 2025
Publication Date September 4, 2025
Submission Date July 27, 2025
Acceptance Date August 31, 2025
Published in Issue Year 2025 Volume: 11 Issue: 5

Cite

AMA Kerimoğlu RS, Kargın S, Maden AS, Duyan AG. Comparison of clinical outcomes of Lichtenstein and laparoscopic totally extraperitoneal repair techniques in inguinal hernia surgery. Eur Res J. September 2025;11(5):1008-1014. doi:10.18621/eurj.1750403


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