Die „spannungsfreie“ Reparation der Leistenhernie: laparoskopisch (TAPP) versus offen (Lichtenstein)

Abstract

In a prospective study, from June 1992 to February 1994 94 patients with 100 hernias were treated laparoscopically (TAPP) and from March 1993 to November 1994 100 patients with 108 hernias were treated with a Lichtenstein patch. Concerning duration of operation, postoperative outcome, complications and return to work, only minor differences were noted. Because of the more demanding and difficult technique, all TAPP procedures were performed by one surgeon, whereas all 11 surgeons of the department performed the Lichtenstein procedure without any learning curve, which demonstrates the simplicity of the procedure. A higher recurrence rate was found for the TAPP procedure (8 vs 0), however the learning curve has to be considered. The Lichtenstein operation is easy to learn and perform, safe, efficient, cheaper (750 DM) and therefore superior to the TAPP procedure. A planned randomized study was cancelled; laparoscopic hernia repair is no longer carried out in our department.