Comparative Analysis of Surgical Outcomes and Recurrence Rates Following TAPP, TEP, and Open Inguinal Hernia Repair: A Retrospective Cohort Study of 146 Patients at Al‑Jala Hospital and Taknis General Hospital, Libya

Abstract

Inguinal hernia repair is one of the most frequently performed operations in general surgery. Open mesh repair and laparoscopic techniques, namely Transabdominal Pre-peritoneal (TAPP) and Totally Extra-peritoneal (TEP) repair, are widely accepted approaches. However, differences in postoperative outcomes and recurrence rates continue to be debated. This study was conducted to compare the surgical outcomes and recurrence rates of TAPP, TEP, and open inguinal hernia repair. A comparative study was conducted among patients who underwent inguinal hernia repair using TAPP, TEP, or open mesh repair. Patient demographics, operative time, length of hospital stay, postoperative pain, complications, time to return to normal activities, and recurrence rates were evaluated. Outcomes were compared among the three surgical groups. Among 146 patients, 40 (27.4%) underwent TAPP repair, 30 (20.5%) underwent TEP repair, and 76 (52.1%) underwent Open Lichtenstein repair. Mean operative time was significantly longer in the laparoscopic groups (TAPP: 85.4 ± 18.2 min; TEP: 78.6 ± 16.4 min) compared with open repair (58.3 ± 14.1 min; p < 0.001). Hospital stays, postoperative pain scores, and time to return to normal activities were significantly lower in the laparoscopic groups. No hernia recurrences were observed during a mean follow-up period of approximately 12 months. TAPP, TEP, and open inguinal hernia repair are safe and effective techniques with comparable recurrence rates. Laparoscopic approaches offer advantages in postoperative recovery, while open repair remains a reliable and cost-effective option. Surgical approach selection should be individualised according to patient characteristics, hernia complexity, available resources, and surgeon expertise.