An assessment of pain and return to normal activity. Laparoscopic herniorrhaphy vs open tension-free Lichtenstein repair.
BACKGROUND
Laparoscopic herniorrhaphy is controversial and deserves critical evaluation.


METHODS
In a randomized prospective study transabdominal preperitoneal laparoscopic herniorrhaphy (n = 24) was compared in patients to the tension-free Lichtenstein repair (n = 29) utilizing validated and reliable pain and activity assessment tools. The Sickness Impact Profile (SIP) was used to compare preoperative normal activity to postoperative activity. A Pain-O-Meter (visual analogue scale plus affective and sensory pain descriptors) assessed intensity of pain. The total pain assessment score and SIP were compared across time (postoperative day 1-42). Analgesic medication was used as a covariate.


RESULTS
The total pain score was less for laparoscopic herniorrhaphy but this did not reach statistical significance. Similarly, the SIP showed modest improvement for laparoscopic herniorrhaphy. No differences between groups were noted for morphine equivalents of administered analgesics or length of hospitalization.


CONCLUSIONS
Further investigation of laparoscopic herniorrhaphy is warranted.
Filipi
C J
CJ
Creighton University School of Medicine, Department of Surgery, 601 N. 30th St., Omaha, NE 68131, USA.
Gaston-Johansson
F
F
McBride
P J
PJ
Murayama
K
K
Gerhardt
J
J
Cornet
D A
DA
Lund
R J
RJ
Hirai
D
D
Graham
R
R
Patil
K
K
Fitzgibbons
R
R
Gaines
R D
RD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012008:Recurrence; D018434:Sickness Impact Profile; D013537:Sutures