Transinguinal Preperitoneal Technique of Inguinal Hernioplasty – A Better Alternative to Lichtenstein Procedure

Abstract

Introduction: The Lichtenstein technique is currently one of the popular methods in practice as it provides very good results consistently. However many patients suffer from wound indurations’ and chronic wound pain which are often underreported. The transinguinal preperitoneal technique (TPT) avoids these complications by placing the mesh in preperitoneal plane by open approach. Materials and Methods: In this study, 71 patients were randomized into two groups one, of which one underwent the Lichtenstein repair and the other preperitoneal repair by TPT. All the patients were followed up for two years. Results: Patients in TPT group had less pain in immediate postoperative period (p - .005), less wound induration and chronic pain on follow-up. Patients were also able to return to work early (p =0.036). Average duration of operation was slightly longer compared to Lichtenstein technique (p < .0061). There was no recurrence in either group on 2 year follow-up. Conclusion: This study shows that TPT provides a better alternative to Lichtenstein technique with decreased incidence of wound complications and chronic groin pain, while having a similar recurrence rate. Preperitoneal mesh placement by open approach in TPT is also easier and eliminates the need for laparoscopy.

Keywords

• hernia repair
• preperitoneal mesh
• lichtenstein complications