A Comparative Observational Study of Laparoscopic Transabdominal Preperitoneal (TAPP) and Open Lichtenstein Repair for Inguinal Hernia

Abstract

Background: Inguinal hernia repair is commonly performed, and both open Lichtenstein and laparoscopic TAPP techniques are established options. This study compared perioperative, recovery, safety, recurrence, and cost outcomes between the two approaches. Methods: This prospective observational comparative study included 86 patients with inguinal hernia, with 43 undergoing open Lichtenstein repair and 43 undergoing laparoscopic TAPP repair. Outcomes included operative time, pain within 24–48 hours using the Visual Analogue Scale, time to return to normal activities, postoperative complications, length of hospital stay, recurrence at 6 months, and treatment expenses. Results: Mean operative time was shorter with open repair than with TAPP (64.12 vs 111.42 minutes; p<0.0001). Mean pain scores were higher after open repair (5.98 vs 4.51; p<0.0001), and return to normal activities was later (6.79 vs 5.33 days; p<0.0001). Mean hospital stay was 2.16 days after open repair and 2.49 days after TAPP (p=0.0288). Mean treatment expense was ₹61,616.93 for open repair and ₹113,362.44 for TAPP (p<0.0001). Postoperative complications occurred in 11.6% and 4.7%, respectively (p=0.4331). Six-month recurrence occurred in 7.0% after open repair and 0% after TAPP (p=0.2412). Conclusion: Laparoscopic TAPP was associated with lower early pain and faster return to normal activities, but with longer operative time, slightly longer hospital stay, and higher treatment cost. Complication and six-month recurrence rates did not differ significantly between groups.