Is Laparoscopic Transabdominal Preperitoneal Hernia Repair more Invasive than Anterior Open Mesh Repair?

Introduction: Tension-free open mesh repair is a popular surgical choice for an inguinal hernia. Laparoscopic Hernia Repair (LAHR) is gradually increasing, however, LAHR is considered more invasive than open mesh repair because the surgical time is longer and has a higher rate of postoperative complications. Aim: To compare the invasiveness of laparoscopic Transabdominal Preperitoneal Hernia Repair (TAPP) with open mesh repair by evaluating surgical time, postoperative stay duration, postoperative complications, and inflammatory marker levels in patients with inguinal hernia. Materials and Methods: This was a prospective comparative clinical study of 104 patients with inguinal hernia who were divided into two groups based on treatment type: TAPP and open mesh repair. Patient characteristics, surgery-related and postoperative factors, postoperative stay duration, and postoperative complications were analysed and compared between the two groups. Continuous data were presented as mean +/- standard deviation and were compared using Student's t-test (two-tailed). Categorical data were compared using Fisher's-exact test. Results: In total, 51 patients underwent TAPP and 53 open mesh repair. Surgical time and postoperative stay duration were not significantly different between the two groups. Similarly, White Blood Cells (WBC) (postoperative days 1 and 3) and C-Reactive Protein (CRP) (day 3) levels were not significantly different between the two groups; however, day 1 CRP levels were significantly lower in the TAPP group than in the open mesh repair group (1.12 +/- 0.81 mg/dL and 2.22 +/- 1.88 mg/dL, respectively; p<0.01). Postoperative surgical complication rates were not significantly different between the two groups. Conclusion: Both TAPP and open mesh repair are safe and feasible procedures. TAPP is comparable to open mesh repair in terms of surgical stress and is less invasive.