LAPAROSCOPIC VERSUS OPEN INGUINAL HERNIOPLASTY: A SYSTEMATIC REVIEW OF POSTOPERATIVE OUTCOMES

Abstract

Introduction: Inguinal hernia is one of the most common conditions affecting the abdominal wall, and surgical treatment can be performed using open or laparoscopic techniques. The Lichtenstein technique remains widely used, while totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) approaches have become increasingly adopted. Objective: To compare postoperative outcomes of laparoscopic and open inguinal hernia repair in adult patients with primary inguinal hernia. Methods: A systematic literature review was performed based on the PICO strategy, including comparative primary studies involving adult patients undergoing laparoscopic repair using TEP or TAPP or open repair using the Lichtenstein technique. Seven studies were analyzed, considering postoperative pain, chronic inguinal pain, complications, operative time, hospital stay, return to usual activities, and recurrence as the main outcomes. Results: Laparoscopic repair generally resulted in lower postoperative pain and a lower incidence of chronic inguinal pain, as well as faster recovery and earlier return to usual activities. Some studies also demonstrated shorter hospital stays and fewer specific postoperative complications. However, operative time showed heterogeneous results among studies, being longer in some and shorter in others. Recurrence rates were generally similar between the techniques, although one trial initially demonstrated a difference favoring open repair, which was subsequently associated with surgeon experience. Conclusion: Laparoscopic inguinal hernia repair offers advantages mainly regarding pain reduction and postoperative recovery, while the Lichtenstein technique remains an effective and safe alternative. The choice of surgical approach should consider patient characteristics, available resources, and the experience of the surgical team.