PROSPECTIVE TRIAL COMPARING LICHTENSTEIN WITH LAPAROSCOPIC TENSION-FREE MESH REPAIR OF INGUINAL-HERNIA

A prospective study of 242 patients with inguinal hernia who underwent tension-free mesh repair by the laparoscopic transperitoneal (n=121) or the open Lichtenstein (n=121) technique was performed. There was no significant difference in operation time between the laparoscopic (me dian (range) 35 (20-90) min) and Lichtenstein (40 (20-90) min) procedu res. Discharge within 24 h of operation was more common after laparosc opic surgery (89.3 per cent versus 48.7 per cent). Consequently, hospi tal stay was reduced with this approach (median (range) 1 (1-7) days v ersus 2 (1-10) days for patients who had a Lichtenstein repair). There was no significant difference in parenteral analgesia requirements or visual analogue pain scores between the two groups. Although use of o ral analgesia in hospital was greater in patients who underwent Lichte nstein hernioplasty, this may reflect their longer stay. Rehabilitatio n to normal activity and return to work was shorter in patients receiv ing laparoscopic repair (median 7 and 10 days, respectively) than Lich tenstein repair (14 and 21 days) (P<0.001). Initial results suggest th at laparoscopic procedures may be associated with more rapid rehabilit ation compared with that of open tension-free mesh surgery. Most patie nts with inguinal hernia undergoing tension-free mesh repair by either technique would be suitable for day-case surgery.