PROSPECTIVE RANDOMIZED TRIAL COMPARING POSTOPERATIVE PAIN AND RETURN TO PHYSICAL-ACTIVITY AFTER TRANSABDOMINAL PREPERITONEAL, TOTAL PREPERITONEAL OR SHOULDICE TECHNIQUE FOR INGUINAL-HERNIA REPAIR

In a prospective randomized study postoperative pain, analgesic consum ption, return to physical activity and work, cosmetic result and exper ience with the type of operation were assessed in 86 patients undergoi ng inguinal hernia repair by means of either the Shouldice technique ( n=34), the laparoscopic transabdominal preperitoneal (TAPP) (n=28) or total preperitoneal (TPP) (n=24) repair. Patients having TAPP repair h ad decreased visual analogue scale scores for pain on the day of opera tion compared with those undergoing TPP and Shouldice repair (4.8 vers us 6.5 and 6.2 respectively, P=0.02) and on the first postoperative da y compared with TPP (4.0 versus 6.0, P=0.01). There was no difference between the three groups for days 2, 3, 4, 5 and 30 after operation. P atient satisfaction with the operation, analgesic consumption, return to physical activity such as walking, driving, climbing stairs, runnin g, bicycling and sexual intercourse, as well as return to work, was co mparable in the three groups. There was a better cosmetic result after TAPP and TPP repair. This study failed to demonstrate significant ben efits from laparoscopic hernia repair over the Shouldice technique.