A Comparative Study of Intraoperative and Postoperative Outcomes in TEP Hernioplasty Versus Lichtenstein Tension - Free Open Hernioplasty: A Focus on Complications, Recovery and Recurrence

Background and Aims: Inguinal hernia repair is one of the most frequently performed surgeries worldwide, with two primary techniques being Lichtenstein tension - free open hernioplasty and laparoscopic Totally Extraperitoneal (TEP) hernioplasty. The Lichtenstein method, though effective in reducing recurrence, often leads to longer recovery times and higher rates of wound complications. TEP hernioplasty offers a minimally invasive alternative with promises of faster recovery and reduced postoperative pain. This study aims to compare intraoperative and postoperative complications, recovery time, and recurrence rates between these two methods. Methods: This prospective, single - center study was conducted at BRD Medical College, Gorakhpur, over a 12 - month period. A total of 51 patients with primary unilateral inguinal hernias (both direct and indirect) were randomized into two groups: TEP hernioplasty and Lichtenstein tension - free open hernioplasty. Data on intraoperative complications, postoperative outcomes, recovery time, and recurrence rates were collected. Ethical approval was obtained from the Institutional Ethics Committee, and informed consent was taken from all participants. Statistical analysis was performed using SPSS version 23.0 with P - values < 0.05 considered statistically significant. Results: The TEP group had a significantly longer operative time (128.10 ? 22.993 min) compared to the Lichtenstein group (49.83 ? 9.237 min), but shorter hospital stays (3.19 ? 0.680 vs.5.13 ? 1.167 days) and quicker return to normal activities (2.52 ? 0.928 vs.5.40 ? 1.276 days). Postoperative pain was lower in the TEP group (5.52 ? 0.928 vs.6.67 ? 0.547), though not statistically significant (P = 0.081). No significant differences were observed in complications such as bowel or vascular injuries, seroma, hematoma, or recurrence. Conclusion: TEP hernioplasty offers advantages in terms of quicker recovery, shorter hospital stays, and reduced postoperative pain, despite a longer operative time. Both techniques demonstrate similar safety profiles with comparable complication and recurrence rates.