Less Early Postoperative Pain with Totally Extraperitoneal Repair Compared to Open Glue Mesh Fixation in Inguinal Hernia Surgery

Abstract

Introduction: TEP and Open Glue Mesh Fixation are the repair process for the inguinal hernia, with comparable outcomes in terms of pain, recovery and other complications. The study objectives is to compare the postoperative outcomes and the effectivity between the TEP and the open glue mesh fixation process.

Method: This is a prospective comparative study with total 60 patients selected with the inguinal hernia. Randomly patients were placed in the two surgical groups TEP and the open Open Glue Mesh Fixation. Different demographic data, the details of the operations and the NRS pain and the use of the analgesic, the complications and the recovery rate were assessed and recorded. Data analysis was done by SPSS 27.0 with t-test, Mann–Whitney U, chi-square, and mixed-model analysis (p<0.05).

Result: The TEP group (Group B) showed significantly lower pain scores than the Lichtenstein group (Group A) from Day 0 to Day 7, with a p-value of 0.002 on Day 2, 0.001 on Days 3, 4, 5, and 6, and 0.005 on Day 7. By Day 21, the TEP group’s pain score was 1.9, significantly lower than the Lichtenstein group’s 2.5 (p=0.002). The TEP group also required fewer analgesics on Days 1 (5.3 vs. 3.5), 2 (4.5 vs. 3.9), 4 (3.9 vs. 2.9), 6 (4.2 vs. 2.5), 7 (2.5 vs. 1.8), and 14 (2.9 vs. 1.15) with p-values ranging from 0.015 to 0.017. These findings highlight faster pain relief and quicker recovery in the TEP group.

Conclusion: The study concluded that the TEP group experiences significantly reduced pain throughout the postoperative period, particularly in the immediate and early stages.

Keywords: Totally Extraperitoneal (TEP) Repair, Inguinal Hernia, Postoperative Pain, Analgesic Use, Recovery Rate