TAPP Versus Lichtenstein Results a Prospective Controlled Comparative Study

Inguinal hernia repair is one of the most common surgical procedures. The best therapeutic option for the primary hernia has been studied, but there still no proof of the ideal approach. Much work has been devoted to the diagnosis and therapy of inguinal hernias, providing recommendations to help surgeons standardize their techniques and improve results. This study compares the results of inguinal hernia repair with the laparoscopic transabdominal preperitoneal procedure (TAPP) and the Lichtenstein technique. Methods: prospective comparative controlled trial conducted between November 2019 and October 2022 (36 months), 400 patients included divided into two groups of 200 patients for each technique. Parameters studied included occurrence of chronic pain beyond 3 months as primary endpoint; duration of operation, postoperative complications, immediate postoperative pain, resumption of daily activities, return to work and sports and quality of life as secondary endpoints. Results: 400 adult male patients with primary unilateral hernias were followed up at 3 months and 363 patients at 6. The TAPP procedure resulted in less early postoperative pain up to 30 days after surgery (p <0.000001), identical operative time (mean 48.75 vs. 48.36. p= 0.69). TAPP caused fewer postoperative complications (p<0.012), and less chronic pain at 3 months (p<0.002, RR=0.42) and at 6 months 1.6% vs 13.8% (p<0.00001, RR=0.125), Faster return to work in the TAPP group 19.64 days vs. 31.8 days (p<0.0001), faster return to daily activities 2.9 days vs. 9.38 days (p<0.0001). Faster return to sporting activities 32.1 days vs. 60 days (p<0.0001). Conclusion: The preperitoneal transabdominal approach for curing a non-recurrent unilateral inguinal hernia is safer and associated with less chronic postoperative pain, and less early postoperative pain. It also has the advantage of enabling patients to return to work and daily activities more quickly, thereby enhancing their quality of life.