231 A Comparative Study Between Open Pre-Peritoneal Approach Versus Laparoscopic Trans-Abdominal Pre-Peritoneal Approach in Recurrent Inguinal Hernia Repair: A Prospective Cohort Study

Abstract Aim To compare the open pre-peritoneal approach and Laparoscopic trans-abdominal pre-peritoneal approach in the management of recurrent inguinal hernia which was previously managed through an open anterior approach regarding their intra-operative time, the post-operative outcomes. Method The current study is a prospective cohort study, a single-center trial conducted from June 2021 to June 2022 at Ain Shams University Hospitals. Results There were 74 patients in our study 37 patients in each group. Group (I) underwent an open pre-peritoneal approach and group (II) underwent a Laparoscopic trans-abdominal pre-peritoneal approach. Regarding intra-operative time, the mean time in minutes in the group (I) is 63.33 with a standard deviation of ±11.95. While in group (II) the mean time in minutes is 81.21 with a standard deviation of ±18.03 (p=0.015). Regarding the hematoma occurred in 4(10.8%) patients in group (I). While in 2(5.4%) patients in group (II) (p=0.674). The wound infection was found in 5 (13.5%) patients in group(I) and zero patients in group (II)(p=0.021). Finally, recurrence after one year was found in 3(8.1%) patients in group(I) and 1(2.7%) patient in group (II) (p=0.615). Conclusions The results of this study demonstrate that both approaches are effective for recurrent inguinal hernia following anterior approach mesh hernioplasty, with comparable results. Laparoscopy has been associated with a lower rate of recurrence and overall complications compared to open technique, however, it is difficult to draw definitive conclusions about the preferred option due to its lengthy learning curve and difficulty to perform.