Abstract

POST-OPERATIVE PAIN AND LENGTH OF HOSPITAL STAY IN OPEN AND LAPAROSCOPIC HERNIOPLASTY - A COMPARATIVE STUDY

Author(s): Ajesh Gopal1, Neenu Vijayakumar2

A hernia is defined as an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Although a hernia can occur at various sites of the body, these defects most commonly involve the abdominal wall, particularly the inguinal region. Hernia repair is one of the most common operations performed by general surgeons. About 75% of all hernias occur in the inguinal region. Two thirds of these are indirect and the remainder are direct inguinal hernias. Femoral hernias represent only 3% of all groin hernias. Open Lichtenstein ’mesh repair and laparoscopic mesh repair are widely being practiced across the world. The aim of this study is to demonstrate the difference in post-operative pain and length of hospital stay in open and laparoscopic methods. MATERIALS AND METHODS The study population included 48 patients who underwent hernia repair surgery in a tertiary care hospital in North Kerala during the period of 2015 to 2017. Patients presented with direct inguinal hernia in surgical OPD were selected and divided into two groups. One group underwent open Lichtenstein s mesh repair and the other group underwent laparoscopic TAPP repair. Post-operatively, pain was assessed 5 hrs after surgery on day 1, 24 hours post-surgery, and on day 7. Length of hospital stay was measured in hours. RESULTS Among the 48 patients with direct inguinal hernia, 28 patients underwent open mesh repair and 20 patients underwent laparoscopic TAPP repair. The mean age of the study population was 50. Post-operative pain was significantly lesser in laparoscopy group with 70% of patients having a pain score of 3 in a scale of 0 to 10. Patients in the open surgery group had pain perception of 5 in a scale of 0-10. The duration of hospital stay was lesser in laparoscopy group, 32 hours compared to the open surgery groups 46 hours. CONCLUSION In patients who underwent laparoscopy, the intensity of post-operative pain was significantly lesser. Length of hospital stay was also shorter in laparoscopy group compared to the patients who had undergone Lichtenstein s repair.