COMPARISON OF LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL (TAPP) VERSUS LICHTENSTEIN REPAIR FOR BILATERAL INGUINAL HERNIAS

Abstract

Background: Inguinal hernias account for the majority of abdominal wall hernias, with up to 20% of patients presenting bilaterally. Surgical management includes open Lichtenstein mesh repair and laparoscopic transabdominal preperitoneal (TAPP) repair, each with distinct advantages. This study compares postoperative outcomes of these two approaches in bilateral inguinal hernia repair, focusing on complications such as seroma, wound infection, and scrotal hematoma. The findings aim to support evidence-based surgical decision-making and improve patient care. Materials and Methods: This randomized controlled trial enrolled 280 patients with primary bilateral inguinal hernias, randomized into Lichtenstein (n=140) and laparoscopic TAPP (n=140) groups. Standardized surgical techniques and perioperative protocols were applied. Outcomes assessed included operative time, hospital stay, and postoperative complications (wound infection, seroma, scrotal hematoma), with data analyzed using SPSS v23. Results: A total of 280 patients were equally randomized to Lichtenstein and TAPP groups with comparable baseline characteristics. Operative time was significantly longer in TAPP (128.6 ± 15.4 vs. 94.3 ± 10.2 min, p < 0.001), but hospital stay was shorter (1.7 ± 0.6 vs. 2.8 ± 0.9 days, p < 0.001). Postoperative complications were fewer in the TAPP group, with significantly lower rates of seroma (p = 0.04) and wound infection (p = 0.02), though scrotal hematoma showed no significant difference. Conclusion: Laparoscopic TAPP repair demonstrated clear benefits over open Lichtenstein repair in bilateral inguinal hernias, with shorter hospitalization and fewer wound-related complications, despite longer operative times. These results endorse TAPP as a safe and effective option, while emphasizing the need for tailored surgical decision-making.