In the surgical treatment of inguinal hernias, is laparoscopic surgery superior to open surgery?

​Objective: Inguinal hernia is one of the most common general surgical pathologies in the world. Although inguinal hernias occur in 3.8% of the population, the ideal repair method is still debated. In this study, we aimed to evaluate the operation times, hospitalisation times, costs and complications such as pain, seroma and recurrence of the Lichtenstein procedure and TAPP method used in inguinal hernia repair and to provide recommendations for general surgeons based on current data. ​Materials and Methods: In this study, we retrospectively analysed the data of 434 patients who underwent surgery for inguinal hernia in the Department of General Surgery of Afyonkarahisar Health Sciences University Faculty of Medicine Hospital between January 2020 and December 2022. Patients with recurrent inguinal hernia, irreduced scrotal hernia, femoral hernia or incarcerated hernia requiring emergency surgery were excluded from the study. As a result of these limitations, the total number of patients included in the study was 353. ​Results: Of the patients, 233 were operated with the laparoscopic TAPP method and 120 were operated with the open Lichtenstein method. Of the 353 patients included in the study, 322 (91.2%) were male and 31 (8.7%) were female, with an age range of 18-88 years and a mean age of 55.01±16.1/year. The laparoscopic surgery group (52.9) was younger than the open surgery group (59.2). Of the 353 inguinal hernia patients in our study, 152 had right, 120 had left and 81 had bilateral hernias. However, the rate of bilateral hernias in laparoscopic surgery was approximately 4 times higher than open surgery. When hospital stay, cost and postoperative numbness parameters were evaluated, a statistically significant difference was found between the two groups (p<0.001). There was no statistically significant difference between the two groups in terms of haematoma, seroma, chronic pain, swelling, scrotal oedema, wound infection, urinary retention and recurrence. ​Conclusion: When the findings of our study and the current literature were analysed, laparoscopic repair was found to be at least as effective and safe as open repair when compared with the Lichtenstein procedure. We think that TAPP method will be the preferred treatment option in inguinal hernia repairs in the future due to its advantages such as shorter hospital stay compared to open surgery, early return to work, minimally invasive, less postoperative pain, allowing evaluation of the contralateral groin and repair of an occult hernia if detected. ​Keywords: Inguinal hernia, Groin hernia, Lichtenstein repair, Transabdominal preperitoneal (TAPP) repair, Recurrence