A prospective comparison of ambulatory endoscopic totally extraperitoneal inguinal hernioplasty versus open mesh hernioplasty

Abstract

Endoscopic extraperitoneal inguinal hernioplasty (TEP) has become an established technique for the repair of inguinal hernia but its application as a day case procedure remains contentious. The objective of the present study is to compare the outcomes of ambulatory TEP and open mesh hernioplasty. From 1 February 2001 to 15 January 2002, a total of 31 patients underwent ambulatory endoscopic extraperitoneal inguinal hernioplasties at our institution. The outcomes of these patients were compared with those of a cohort of 31 patients who underwent ambulatory open mesh hernioplasty during the same period. The operation time, time taken to ambulate and micturate after surgery, postoperative morbidity and unplanned admission rates were similar between the two groups. Pain scores upon coughing on postoperative days 0, 1, 4, 5 and 6 were significantly lower in patients who underwent ambulatory TEP than those who had open mesh repairs. In conclusion, ambulatory endoscopic TEP conferred a significant reduction of postoperative pain scores compared with open repair. TEP is a safe and efficacious technique for the repair of inguinal hernia in an ambulatory setting. It should be a therapeutic option for day case repair of inguinal hernia. © 2003 Elsevier B.V. All rights reserved.