Laparoscopic preperitoneal mesh repair or tension-free mesh plug technique? A prospective study of 471 patients with 543 inguinal hernias.

AbstractObjective: To compare two modern mesh-based “tension free” hernioplasties, laparoscopic repair and mesh plug technique.Design: Prospective, non-randomised study.Setting: Two major medical centres, Greece.Subjects: 471 patients with 543 inguinal hernias.Intervention: Patients entering the study were treated in two major medical centres either by laparoscopic repair under general anaesthesia (n = 237) in hospital A, or by insertion of a mesh plug under monitored local, epidural, or spinal anaesthesia (n = 234) in hospital B. Patients with known bilateral inguinal hernias, femoral hernias, and those with both inguinal hernias and cholelithiasis were encouraged to undergo laparoscopic repair.Main outcome measures: Operative time, hospital mortality, morbidity and length of stay, costs, time to return to work, and recurrence rate.Results: The median operative time for laparoscopic repair was significantly longer (57 compared with 33 minutes, p < 0.001). Laparoscopic repair was more costly (US$1200 comp...