Bassini repair compared with laparoscopic repair for primary inguinal hernia: a randomised controlled trial.

OBJECTIVE

To compare the effectiveness of open and laparoscopic primary inguinal hernia repair.

DESIGN

Randomised controlled trial.

SETTING

University hospital, The Netherlands.

SUBJECTS

87 patients had 103 open repairs and 88 patients had 114 laparoscopic repairs between November 1993 and July 1995.

INTERVENTIONS

Laparoscopic repair by the transabdominal preperitoneal (TAPP) technique and open repair by the Bassini technique.

MAIN OUTCOME MEASURES

Recurrence, morbidity, pain, and duration of convalescence.

RESULTS

Operating time was longer for laparoscopy (mean (SD): 82 (28) compared with 45 (15) minutes p < 0.001). Patients in the Bassini group had higher postoperative pain scores (mean (SD)VAS: 2.9 (1.6) compared with 2.0 (1.6) p=0.002), used more analgesics (median total intake: 2 (0-54) compared with 0 tablets (0-42) p=0.008), and needed a longer convalescence time (mean (SD) time to return to work: 22 (12.6) compared with 14 (10.1) days p < 0.001; mean (SD) time to return to physical activities: 27 (12.6) compared with 17 (12.2) days p < 0.001). Mean follow up was 24 months. Recurrence rates were 21% (22/ 103) after Bassini and 6% (7/114) after laparoscopic repair (p=0.001).

CONCLUSION

Laparoscopic hernia repair is a safe operation, which has obvious advantages over the Bassini repair in terms of pain, use of analgesic drugs, resumption of activities, and recurrence. A disadvantage of the laparoscopic repair is the longer operating time.