Abstract
Background. The laparoscopic repair of unilateral primary groin hernia remains controversial.
This randomized study evaluates the outcome of the laparoscopic technique in hernia
repair in patients undergoing simultaneous laparoscopic cholecystectomy (LC) and compares
laparoscopic repair with tension-free open groin hernia repair. Methods. Sixty-four low-risk patients with symptomatic chronic calculous cholecystitis and
synchronous unilateral primary inguinal hernia were randomized to undergo either laparoscopic
transabdominal preperitoneal mesh hernia repair (TAPP) and LC or LC and open tension-free
hernia repair. Results. The operating time was longer in the TAPP and LC group (mean ± SD = 121 ± 32 minutes)
than in the LC and open group (95 ± 27 minutes) (P <.01). The mean operating costs were higher in the TAPP and LC group ($1235 versus
$1080) (P <.03). The intensity of postoperative pain at rest was greater in the LC and open group
at 24 hours (P <.01) and 48 hours (P <.05), with a greater consumption of pain medication (P <.01). No differences between the 2 groups were found in terms of postoperative complications,
disability period before return to work, or hernia recurrences. Conclusions. The totally laparoscopic procedure does not result in a significant benefit other
than improved comfort in the first 2 postoperative days. However, laparoscopic hernia
repair is considerably more difficult to perform than open tension-free hernioplasty.
Thus, the totally laparoscopic approach should be performed only by experienced laparoscopic
surgeons with special expertise in hernia surgery. (Surgery 2001;129:530-6.)
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References
- Laparoscopic versus open inguinal hernia repair: randomized prospective trial.Lancet. 1994; 343: 1243-1245
- A randomized comparison of physical performance following laparoscopic and open inguinal hernia repair. The Coala Trial Group.Br J Surg. 1997; 84: 64-67
- A prospective, randomized study of open vs laparoscopic inguinal hernia repair. An assessment of postoperative pain.Arch Surg. 1997; 132: 292-295
- Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair.N Engl J Med. 1997; 336: 1541-1547
- A randomized, controlled, clinical study of laparoscopic versus open tension-free inguinal hernia repair.Surg Endosc. 1998; 12: 979-986
- Laparoscopic vs open inguinal hernia repair. A randomized controlled trial.Surg Endosc. 1998; 12: 846-851
- A randomized prospective controlled trial of laparoscopic extraperitoneal hernia repair and mesh-plug hernioplasty: a study of 315 cases.J Laparoendosc Adv Surg Tech A. 1998; 8: 367-372
- Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial.Surg Endosc. 1999; 13: 323-327
- Randomized clinical trial of laparoscopic versus open inguinal hernia repair.Br J Surg. 1999; 86: 316-319
- Tension-free laparoscopic and open hernia repair: randomized controlled trial of early results.World J Surg. 1999; 23: 1004-1007
- Laparoscopic versus open repair of groin hernia: a randomized comparison.Lancet. 1999; 354: 185-190
- Prospective randomized study comparing laparoscopic and open tension-free inguinal hernia repair with Shouldice's operation.Am J Surg. 1998; 175: 330-333
- Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study).Ann Surg. 1999; 230: 225-231
- Overview of randomized trials in laparoscopic inguinal hernia repair.Semin Laparosc Surg. 1999; 5: 238-241
- Laparoscopic or open herniorrhaphy? A randomized prospective trial.Arch Surg. 1994; 129: 973-979
- Total costs of laparoscopic and Lichtenstein inguinal hernia repairs: a randomized prospective study.Surg Laparosc Endosc. 1997; 7: 1-5
- Update: what is left for laparoscopic hernia repair?.Dig Surg. 1998; 15: 167-171
- Simultaneous repair of bilateral groin hernias: open or laparoscopic approach?.Surg Laparosc Endosc. 1998; 8: 313-318
- Calculous biliary disease.in: Surgery: scientific principles and practice. : JB Lippincott Company, Philadelphia1993: 936-953
- Inguinal anatomy and abdominal wall hernias.in: Surgery: scientific principles and practice. : JB Lippincott Company, Philadelphia1993: 1081-1107
- Coelioscopic cholecystectomy, preliminary report of 36 cases.Ann Surg. 1990; 211: 60-65
- Critical scrutiny of open “tension-free” hernioplasty.Am J Surg. 1993; 165: 369-371
- Laparoscopic hernia repair: the learning curve.Surg Laparosc Endosc. 2000; 10: 149-153
- Laparoscopic groin hernia repair: results of 200 consecutive herniorrhaphies.Br J Surg. 1995; 82: 618-620
- Cooperative hernia study.Ann Surg. 1996; 224: 598-602
- Nerve injury associated with laparoscopic inguinal herniorrhaphy.Surgery. 1995; 118: 829-833
- Individualization of hernia repair: a new era.Surgery. 1993; 114: 1-2
- Pefloxacin vs cefotaxime prophylaxis in elective biliary tract surgery.J Chemother. 1993; 5: 375-376
Article info
Publication history
Accepted:
November 12,
2000
Footnotes
*Reprint requests: Leopoldo Sarli, Istituto Clinica Chirurgia Generale e Terapia Chirurgica, Azienda Ospedale, Via Gramsci n. 14, 43100 Parma, Italy.
**Surgery 2001;129:530-6.
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
