A comparative study of the incidence of postoperative meralgia paraesthetica after open inguinal hernioplasty and after laparoscopic transabdominal preperitoneal approach repair for recurrent inguinal hernia

Objective
The aim of this prospective study was to compare the postoperative incidence and the intensity of pain and meralgia paraesthesia in both the laparoscopic transabdominal preperitoneal approach (TAPP) and the open approach for patients with recurrent inguinal hernia.
Patients and methods
A total of 80 patients with recurrent inguinal hernia were selected and operated in the same surgical unit from December 2011 to January 2014. About 40 patients were operated by TAPP and 40 patients with the open surgical technique. We compared the two techniques in terms of the postoperative pain and paraesthesia using the quality of life and the time to return to normal activity. We evaluated postoperative paraesthesia and pain using the visual analog scale.
Results
Our results revealed the superiority of the laparoscopic approach over the open technique in generality, with less incidence of pain and paraesthesia. During the early postoperative period, pain had been abolished completely on the sixth to the seventh day in 37 patients in the laparoscopic (LAP) group, whereas in the open approach (OPEN), it was achieved in only 25 patients. During the late postoperative period, only three patients in the LAP group continued to complain after the first week, whereas in OPEN group, 15 patients continued to complain of pain. In the OPEN group, there were five patients with severe paraesthesia persisting for more than 6 months, whereas in the LAP group, all patients improved before the sixth month.
Conclusion
Postoperative pain and paraesthesia are an important issue in inguinal hernia surgery; hence, long-term follow-up is important. The best approach for recurrent inguinal hernia repair with the least postoperative pain and paraesthesia are the TAPP, with superiority over the open approach.