title: Transinguinal preperitoneal technique of inguinal hernioplasty - a better alternative to lichtenstein procedure.
abstract: BACKGROUND
  The Lichtenstein technique is currently one of the popular methods in practice as it provides very good results consistently. However many patients suffer from wound indurations' and chronic wound pain which are often underreported. The transinguinal preperitoneal technique (TPT) avoids these complications by placing the mesh in preperitoneal plane by open approach.
  
  
  METHODS
  In this study, 71 patients were randomized into two groups one, of which one underwent the Lichtenstein repair and the other preperitoneal repair by TPT. All the patients were followed up for two years.
  
  
  RESULTS
  Patients in TPT group had less pain in immediate post-operative period (p - .005), less wound induration and chronic pain on follow-up. Patients were also able to return to work early (p =0.036) . Average duration of operation was slightly longer compared to Lichtenstein technique (p < .0061) .There was no recurrence in either group on 2 year follow-up.
  
  
  CONCLUSIONS
  This study shows that TPT provides a better alternative to Lichtenstein technique with decreased incidence of wound complications and chronic groin pain, while having a similar recurrence rate. Preperitoneal mesh placement by open approach in TPT is also easier and eliminates the need for laparoscopy.
authors.affiliation: Senior Resident, Department of Surgical Gastroenterology, School of Digestive and Liver Diseases , IPGMER, Kolkata, India .
authors.forename: Rubik
authors.initials: R
authors.lastname: Ray
authors.affiliation: Professor, Department of General Surgery, Malda Medical College , Kolkata, India .
authors.forename: Manoranjan
authors.initials: M
authors.lastname: Kar
authors.affiliation: HOD, Department of General Surgery, College of Medicine and Sagar Dutta Hospital , Kolkata, India .
authors.forename: Mrityunjay
authors.initials: M
authors.lastname: Mukhopadhyay
keywords: Hernia repair; Lichtenstein complications; Preperitoneal mesh