RCTs regarding inguinal hernia repair approaches
| Study | Design | Subjects | Disease | Follow-up time | Outcome measures | Conclusion |
| Akhtar et al.11 | RCT | TAPP (n=30) Lichtenstein (n=50) | Unilateral inguinal hernia | 6 months | Average operation, pain score, analgesics, admission days, days required to return to work | Laparoscopic hernia surgery is better than Lichtenstein repair in terms of postoperative pain, hospital stay and return to daily activity. |
| Sarhan et al.12 | RCT | A total of 200 patients scheduled for unilateral inguinal hernia repair were randomly divided into two groups to undergo either laparoscopic TAPP (group A) or open modified Kugel procedure | Unilateral inguinal hernia | 32 months | Recurrence and short-term and long-term complications | Both open modified Kugel and laparoscopic TAPP preperitoneal repair techniques for inguinal hernia are safe and effective with low recurrence rates. Laparoscopic approach has better outcome in terms of chronic pain, short operative time and short duration of hospital stays. |
| Kargar et al.13 | RCT | TAPP (n=60) Lichtenstein (n=60) | Inguinal herniajrnlTblFoot | Follow-up occurred within 6 weeks. | Pain score (VAS), haematoma/seroma, urinary retention, wound infection, hospital stay | The laparoscopic TAPP repair is safer and less complicated approach for inguinal hernia repair. The two main short-term advantages of the laparoscopic TAPP repair with the tension free Lichtenstein repair were less postoperative pain and earlier return to the normal life activities. No difference was seen in overall complications. |
| Salma et al.14 | RCT | TAPP (n=30) Lichtenstein (n=30) | Direct inguinal hernia | Postoperative pain intensity assessed by VAS and hospital stay measured in hours. | Hospital stay, immediate post operative pain | There is less postoperative pain after laparoscopic repair but hospital stay is same in both the procedures but laparoscopic procedure does increase the cost. |
| Bahram15 | RCT | TAPP (n=150) Lichtenstein (n=150) | Inguinal herniajrnlTblFoot | Three hundred patients with inguinal hernia were enrolled in this study, divided into two equal groups: Group I managed by TAPP laparoscopic repair and group II managed by open lichtenstein repair. | Operative time, intraoperative visceral injury, ileus, hospital stay or wound complications, postoperative pain, groin hypothaesia, return to activities, recurrence | TAPP technique is an excellent approach for treatment of inguinal hernia in comparison to LR either unilateral or bilateral, primary or recurrent inguinal hernia with low morbidity and recurrence comparable to that oflichtenstein repair with advantages of less postoperative pain and early return to activities. |
LR, laparoscopic repair; RCT, randomised controlled trial; TAPP, transabdominal preperitoneal; VAS, Visual Analogue Scale.