Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair

A. Pisanu, M. Podda, A. Saba, G. Porceddu, A. Uccheddu

Research output: Contribution to journalArticle


Purpose: The hypothesis of this meta-analysis was to assess whether laparoscopic approach shows real benefits over Lichtenstein technique in recurrent inguinal hernia repair. Methods: A literature search for prospective randomized trials comparing laparoscopic and Lichtenstein procedure in recurrent inguinal hernia repair was performed. Trials were reviewed for primary outcome measures: re-recurrence, chronic inguinal pain and ischemic orchitis; and for secondary outcome measures. Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for dichotomous variables. Results: Seven studies comparing laparoscopic and Lichtenstein technique were considered suitable for the pooled analysis. Overall 647 patients with recurrent inguinal hernia were randomized to either laparoscopic repair (333, 51.5 %, transabdominal preperitoneal approach, TAPP and totally extraperitoneal approach, TEP) or anterior open repair (314, 48.5 %, Lichtenstein operation). Patients who underwent laparoscopic repair experienced significantly less chronic pain (9.2 % vs. 21.5 %, p = 0.003). Patients of the laparoscopic group had a significantly earlier return to normal daily activities (13.9 vs. 18.4 days, SMD = −0.68, 95 % CI = −0.94 to –0.43, p 

Original languageEnglish
Pages (from-to)355-366
Number of pages12
Issue number3
Publication statusPublished - Jul 18 2014



  • Anterior open approach
  • Laparoscopic approach
  • Lichtenstein operation
  • Prospective randomized trial
  • Recurrent inguinal hernia repair
  • TAPP
  • TEP
  • Totally extraperitoneal approach
  • Transabdominal preperitoneal approach

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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