Analysing the Outcomes of Open Versus Laparoscopic Surgical Technique in Inguinal Hernia Repair
Authors
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
Background: Open Lichtenstein and laparoscopic (TAPP/TEP) mesh repairs are standard for inguinal hernia, yet real-world patient allocation frequently deviates from randomisation, introducing confounding by indication. Methods: Retrospective cohort study of 250 randomly sampled adult patients (125 open, 125 laparoscopic) undergoing elective inguinal hernia repair at PSG Hospitals, Coimbatore, India (2019-2023). Baseline characteristics were compared using χ² or Fisher’s exact test. Results: Patients undergoing open repair were significantly older (61.6% vs 28.0% >50 years, p<0.001) and exhibited higher prevalence of hypertension (28.8% vs 16.8%, p=0.025), coronary artery disease (10.4% vs 3.2%, p=0.022), chronic lung disease (17.6% vs 8.8%, p=0.041), and benign prostatic hypertrophy (9.6% vs 3.2%, p=0.038). Diabetes prevalence was comparable (16.8% vs 16.0%, p=0.869). Direct hernias predominated. Six recurrent cases were included (2 open, 4 laparoscopic, p=0.68). No significant family history was recorded. Conclusion: Both methods are safe and effective. Laparoscopic repair provides advantages in postoperative recovery and shorter hospitalisation, whereas open repair remains appropriate for patients unsuitable for general anaesthesia. Selection of technique should be guided by patient factors and surgeon expertise.
##plugins.themes.bootstrap3.article.details##
Copyright (c) 2026 Dr. Kamalraj Sundaramoorthy, Mr. Goutham Anaimallur Janardhanan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
[1] Neumayer L, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 2004; 350:1819-27.
[2] O'Reilly EA, et al. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair. Ann Surg 2012; 255:846-53.
[3] McCormack K, et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003;(1):CD001785.
[4] Rutkow IM. Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States. Surg Clin North Am 1998; 78:941-51.
[5] Hernia Surge Group. International guidelines for groin hernia management. Hernia 2018; 22:1-165.
[6] Simons MP, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009; 13:343-403.
[7] Eklund A, et al. Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein repair. Br J Surg 2010; 97:600-8.
[8] Wake BL, et al. Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques. Cochrane Database Syst Rev 2005;(1):CD004703.
[9] Amid PK. Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 2004; 8:1-7.
[10] Bittner R, et al. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia. Surg Endosc 2011; 25:2773-843.
[11] Krishna A, et al. Laparoscopic inguinal hernia repair: a prospective multicentre trial in India. Hernia 2012; 16:277-84.
[12] Misra MC, et al. Laparoscopic versus open repair of inguinal hernia: a critical review. World J Laparosc Surg 2008;1:1-9.
[13] Antoniou SA, et al. Transabdominal preperitoneal versus totally extraperitoneal repair: a systematic review and meta-analysis. Hernia 2017; 21:343-55.
[14] Schmedt CG, et al. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques. Surg Endosc 2005; 19:188-99.
[15] Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res 2011; 46:399-424.
[16] Haukoos JS, Lewis RJ. The propensity score. JAMA 2015;314:1637-8.
[17] von Elm E, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Lancet 2007; 370:1453-7.
[18] Jansen PL, et al. Risk factors for early recurrence after inguinal hernia repair. BMC Surg 2009;9:18.
[19] Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet 2003; 362:1561-71.
[20] Fitzgibbons RJ Jr, et al. Long-term results of a randomized controlled trial of a nonoperative strategy for men with minimally symptomatic inguinal hernias. Ann Surg 2013; 258:508-15.
[21] AlMahroos MA, et al. Laparoscopic versus open inguinal hernia repair: a systematic review and meta-analysis. Int J Surg 2022; 104:106767.
[22] Rajendran, Kathiravan1; Udayakumar, Sharath2; Dhandapani, Abinaya1. Assessment of Depression, Anxiety, Stress and Eating Disorders among Pre-professional Coaching Students in Udaipur: A Cross-sectional Study. NMO Journal (): 10.4103/JNMO.JNMO_83_25, January 07, 2026. | DOI: 10.4103/JNMO.JNMO_83_25
[23] Misra MC, Bansal VK, Kumar S, et al. Current status of laparoscopic inguinal hernia repair in India. J Minim Access Surg 2021; 17:1-4.