Virendra Nanaji Zambare


Objective:  To compare the intensity of postoperative pain between the surgical techniques Lichtenstein and transabdominal pre-peritoneal laparoscopy for the treatment of unilateral primary inguinal hernia


Materials and Methods: Total of 60 patients were included of which 30 were operated through the Lichtenstein technique and 30 patients through the transabdominal pre-peritoneal laparoscopy. The pain levels were evaluated through the analogue visual scale for 2, 10 and 30 days after the surgery.


Results: The pain levels were significantly lower for the patients operated through the transabdominal pre-peritoneal laparoscopy technique compared to the Lichtenstein technique. Furthermore, despite no recurrent hernias for both surgical techniques, 32 % of patients operated through the Lichtenstein technique reported chronic pain and paresthesia 12 months after the surgery, compared with 3,6% of patients operated through the transabdominal pre-peritoneal laparoscopy technique.


Pain, postoperative; Visual analog scale; Hernia

Full Text:



Aasvang EK, Gmaehle E, Hansen JB, Gmaehle B, Forman JL, Schwarz J. Predictive risk factors for persistent postherniotomy pain. J Amer Soc Anesthe. 2010;112(4):957–969.

Amid PK, Shulman AG, Lichtenstein IL. Open "tension-free" repair of inguinal hernias; The Lichtenstein technique. Eur J Surg. 1996;162(6):447–453.

Amid PK. Lichtenstein tension-free hernioplasty its inception, evolution, and principles. Hernia. 2004;8(1):1–7.

Bittner R, Schwarz J. Inguinal hernia repair current surgical techniques. Langenbeck's Arch Surg. 2011;397(2):271–282.

Bosi HR, Guimaraes JR, Cavazzola LT. Robotic assisted single site for bilateral inguinal hernia repair. ABCD, Arq Bras Cir Dig. 2016;29(2):109–111.

Chung L, Norrie J, O'Dwyer PJ. Long-term follow-up of patients with a painless inguinal hernia from a randomized clinical trial. Br J Surg. 2011;98(4):596–599.

Eker HH, Langeveld HR, Klitsie PJ, van't Riet M, Stassen LP, Weidema WF. Randomized clinical trial of total extraperitoneal inguinal hernioplasty vs Lichtenstein repair a long-term follow-up study. Arch Surg. 2012;147(3):256–260.

Eklund A, Montgomery A, Bergkvist L, Rudberg C. Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg. 2010;97(4):600–608.

Garg P. Lichtenstein hernioplasty versus totally extraperitoneal laparoscopic hernioplasty in treatment of recurrent inguinal hernia a prospective randomized trial. Ann Surg. 2009;250(3):504–504.

Iuamoto LR, Kato JM, Meyer A, Blanc P. Laparoscopic totally extraperitoneal (TEP) hernioplasty using two trocars anatomical landmarks and surgical technique. ABCD Arq Bras Cir Dig. 2015;28(2):121–123.

Keller J, Muo C-H, Lan Y-C, Sung F-C, Lo F-E, Chiang K-Y. A nation-wide population-based study of inguinal hernia repair incidence and age-stratified recurrence in an Asian population. Hernia. 2015;19(5):735–740.

McCormack K, Scott N, Go P, Ross S, Grant A. Laparoscopic techniques versus open techniques for inguinal hernia repair (review) Cochrane Database of Systematic Reviews. 2003;1(1):CD001785–CD001785.

Myers E, Browne KM, Kavanagh DO, Hurley M. Laparoscopic (TEP) Versus Lichtenstein Inguina Hernia Repair A Comparison of Quality-of-Life Outcomes. Wor J Surg. 2010;34(12):3059–3064.

Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R, Jr, Dunlop D, Gibbs J. Open mesh versus laparoscopic mesh repair of inguinal hernia. New Eng J Med. 2004;350(18):1819–1827.

Palermo M, Acquafersca PA, Bruno M, Tarsitano F. Hernioplasty with and without mesh analysis of the immediate complications in a randomized controlled clinical trial. ABCD, Arq Bras Cir Dig. 2015;28(3):157–160.

Poobalan AS, Bruce J. A review of chronic pain after inguinal herniorrhaphy. Clinc J Pain. 2003;19(1):48–54.


  • There are currently no refbacks.