الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer.
The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall.
A great revolution in inguinal hernia repair surgery occurred during the last two decades with the introduction of tension-free hernia repair by Lichtenstein in 1989. Because of its effectiveness and simplicity, it has almost replaced sutured repair and become the current gold standard.
The preperitoneal approach for mesh insertion is an attractive alternative technique with many advantages as it makes all potential hernia sites exposed helping in rapid diagnosis and repair. It allows for application of a mesh that is of larger size, better overlap and without the need of fixation. It is suitable for treatment of recurrence after classic repairs.
Nyhus, Stoppa, and Wantz are among the famous leaders who adopted the open preperitoneal repair. Nyhus incorporated a preperitoneal slit Prolene mesh in addition to the approximation of the transversalis fascia to Cooper‘s ligament. Stoppa developed GPRVS, which utilized midline incision to insert a large chevron- shaped
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―Dacron” mesh that entirely and bilaterally replaced the transversalis fascia over the myopectineal orifice of Fruchaud without repairing the defective wall. Wantz utilised Stoppa‖s technique to one side and fixed the upper border of his diamond- shaped ―Mersilene” mesh to the incision ―unilateral GPRVS‖.
Results obtained from those techniques were attractive enough to make them compete with the classic repairs in the treatment of recurrent and even primary inguinal hernias.
Meanwhile, in the early 1990s, a second revolution in the treatment of inguinal hernia occurred with the application of laparoscopic surgery. It combines the advantages of minimally invasive surgery, tension free repair and mesh hernioplasty.
Two laparoscopic techniques have become the most commonly used: the transabdominal preperitoneal repair (TAPP) and the totally extraperitoneal (TEP) endoscopic repair.
The first TEP inguinal hernia repair was described by McKernan in 1993. This approach involves preperitoneal dissection and mesh placement without entering into the abdominal cavity. It is preferred over TAPP as it is less invasive and preserves the “peritoneal sanctity”.
Both of the posterior open preperitoneal and the endoscopic TEP were dominated by the simpler and more fashionable Lichtenstein and TAPP repairs. As general laparoscopic skills and experience increased, there has
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been gradual shift from TAPP to TEP. TEP is now in turn, reviving back the concept of posterior open preperitoneal repair.
In the current study we aimed to Comparison between the outcomes of laparoscopic repair and open repair of inguinal hernia.50 patients.the selected patients were randomized into 2 groups by the closed envelop method, 25 patients underwent open repair operation.25 patients underwent laparoscopic repair operation
Result
- In the current study we found that mean age among studied groups was 40.44 with insignificant differences between two groups as regard sex, age and BMI p-value 0.685, 1.00 and 0.745 respectively, there was insignificant differences between two groups as regard smoking p-value 0.688. There was insignificant differences between two groups as regard hernia type p-value 0.399
- That mean duration of operation in laparoscopic group was longer than open group but differences still insignificant p-value 0.399, as regard length of hospital stay there was significant differences between two groups p-value <0.001
- There was insignificant differences between study groups as regard intra operative, post operative and general complications p-value 0.909, 0.645, 0.553 respectively