CONTROLLED MULTICENTER TRIAL OF LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL HERNIOPLASTY VS SHOULDICE HERNIORRHAPHY - EARLY RESULTS

Background: In February 1993 a prospective randomized multicenter tria l was initiated to compare laparoscopic transabdominal preperitoneal h ernioplasty to Shouldice herniorrhaphy as performed by surgeons of non specialized clinics. Methods: Until January 1994, 87 patients with 108 hernias took part in the trial (43 Shouldice and 44 laparoscopic repa irs). Results: The laparoscopic procedure took significantly longer th an did the open operation but caused less pain as measured by pain ana logue score and consumption of paracetamol and narcotics. The postoper ative complication rate was 26% in the ope and 16% in the laparoscopic group. The patients in the laparoscopic group were discharged earlier and their convalescence was shorter than after open hernia repair. Th ere has been one early recurrence in the laparoscopic and two in the o pen group to date with a mean follow-up of 201 days. Conclusions: Lapa roscopic hernia repair causes less pain than the conventional operatio n and enables the patient to return to full work and usual activities earlier. The recurrence rate will not be known for 5 years.