الفهرس 
Anatomy of the Groin (Inguinal Region)Only 14 pages are availabe for public view
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Abstract
Background: Inguinal hernias are common surgical disorders and surgical repair of inguinal hernia remains one of the most common operations in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years until the introduction of synthetic mesh. This mesh can be placed by either using an open approach or by using a minimal access laparoscopic technique. Aim of the Work: Is to compare between open tension-free mesh repair and laparoscopic transabdominal preperitoneal hernioplasty (TAPP) in treating patients with inguinal hernia. Patients and Methods: This randomized control clinical trial was done at Mounira general hospital over a period from March 2017 to February 2018 on the basis of. It included 50 adult patients with inguinal hernia divided randomly into 2 equal groups: group A (n: 25 patients) underwent laparoscopic (TAPP) repair. group B (n: 25 patients) underwent open mesh repair. Results: There was a highly significant difference between the two study groups as regard the operative time, in the laparoscopic group the mean operative time was 79.4±8.3 minutes, while in the open technique group the mean time was 66±15.14 minutes. As regard the post-operative pain, there was a highly significant difference between the two study groups; in the laparoscopic group the mean post-operative pain was 1.88±1; while in the open technique it was 3.52±1.53. Similarly, a significant difference between the two study groups was present as regard the hospital stay, in laparoscopic group the mean stay was 1.48±0.96 days while in the open technique group it was 2.0±0.7 days. As regard time to return to work, in the laparoscopic group, the mean time was 15.2±1.7 days while in the in the open technique group, it was 22.8±2.2 days which was statistically highly significant. This study has shown that 12% of cases in the laparoscopic group had early complication compared to 36% among open group which is significantly different. However, no significant difference was found between the two groups as regard occurrence of late complication, as 8% of laparoscopic group had late complications compared to 12% of open group. Conclusion: We conclude that laparoscopic hernia surgery is better than Lichtenstein repair in terms of less postoperative pain, less analgesia during recovery and an earlier discharge and return to daily work with lower incidence of post-operative complications hence higher patient satisfaction. As far as learning curve of laparoscopy is concerned, with training and experience it is not a problem. If there are any contraindications for the laparoscopy, Lichtenstein repair should be the operation of choice. Recommendations: Further studies on a larger scale of patients are needed to confirm the results obtained by this work.