Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and shorter recovery period.

Objectives: We have presented our experience on laparoscopic inguinal hernia tension-free repair and comparing it with the open one.

Patients and Methods: This is a retrospective study of cases undergone tension-free mesh inguinal hernia repair between July 2008 and October 2011. Cases were divided into two groups. Group I included cases that were repaired by the laparoscopic transabdominal preperitoneal (TAPP) approach and II by the open. Cases were compared regarding the operation time, the postoperative pain (early and long-term), the postoperative scrotal-related and wound complications and the recurrence as well as the cost.

Results: The study included 217 cases; 114 in the group I and 103 in the group II. The operation time was significantly longer in the TAPP group (76.5 ± 18 vs. 67.6 ± 20 minutes). However, the overall hospital stay was less (2.6 ±0.79 vs. 2.9 ±0.87 days.) Early postoperative pain scores in the groups I and II were 0.95 ± 1.36 and 1.48 ± 1.47 and long-term pain and numbness were9% and 7.5% respectively, which were not significantly different between the two groups. The postoperative scrotal-related complications occurred more in the laparoscopic group (15% vs. 7.5%). Local wound complications were significantly more in the open technique (1.8% vs.12%, groups I and II, respectively). Twelve (11%) cases in the group I undergone treatment of an incidentally discovered pathology during laparoscopy including; other side inguinal hernia (7), adhesions (4) and abdominal testis (1). The recurrence rates were 4.3% and 2.4% in the group I and II correspondingly.

Conclusions: Laparoscopic TAPP inguinal hernia repair has longer operation time and more cost than the open technique. Local wound complications were more prevalent in the open repair. The postoperative pain, the hospital stay, the scrotal-related complications as well as the recurrence rates were the same in the both groups. The laparoscopy can detect and treat other intra-abdominal pathologies which have not been diagnosed preoperatively.