BASSINI REPAIR COMPARED WITH LAPAROSCOPIC REPAIR FOR PRIMARY INGUINAL-HERNIA - A RANDOMIZED CONTROLLED TRIAL

Objective: To compare the effectiveness of open and laparoscopic prima ry inguinal hernia repair. Design: Randomised controlled trial. Settin g: University hospital, The Netherlands. Subjects: 87 patients had 103 open repairs and 88 patients had 114 laparoscopic repairs between Nov ember 1993 and July 1995. Interventions: Laparoscopic repair by the tr ansabdominal preperitoneal (TAPP) technique and open repair by the Bas sini technique. Main outcome measures: Recurrence, morbidity, pain, an d duration of convalescence. Results: Operating time was longer for la paroscopy (mean (SD): 82 (28) compared with 45 (15) minutes p < 0.001) . Patients in the Bassini group had higher postoperative painscores (m ean (SD)VAS: 2.9 (1.6) compared with 2.0 (1.6)p = 0.002), used more an algesics (median total intake: 2 (0-54) compared with 0 tablets (0-42) p = 0.008), and needed a longer convalescence time (mean (SD) time to return to work: 22 (12.6) compared with 14 (10.1) days p < 0.001; mea n (SD) time to return to physical activities: 27 (12.6) compared with 17 (12.2) days p < 0.001). Mean follow up was 24 months. Recurrence ra tes were 21% (22/ 103) after Bassini and 6% (7/114) after laparoscopic repair (p = 0.001). Conclusion: Laparoscopic hernia repair is a safe operation, which has obvious advantages over the Bassini repair in ter ms of pain, use of analgesic drugs, resumption of activities, and recu rrence. A disadvantage of the laparoscopic repair is the longer operat ing time.