{"id":{"repo_id":"aachen","oai_identifier":"oai:publications.rwth-aachen.de:51181"},"canonical_url":"https://search.dev.ndltd.org/etd/aachen/oai:publications.rwth-aachen.de:51181","repository":{"repo_id":"aachen","name":"RWTH Aachen University","base_url":"https://publications.rwth-aachen.de/oai2d"},"display":{"title":"Lichtensteinreparation versus TAPP : prospektive Untersuchung eines Patientenjahrganges am Bethlehem-Krankenhaus über zwei Jahre","abstract":"In early 2004, the multi-center study by Neumayer put in question very good results of laparoscopic repair of inguinal hernia, which were achieved in Germany, especially those presented by Bittner and Köckerling. Hence, the idea of this study: we wanted to provide comparative analysis of all current methods available for treatment of inguinal hernias in hospital setting. We aimed to achieve maximum possible coverage to produce reliable patient-centered results, resorting to further investigation in uncertain cases. In this prospective cohort study, we followed patients with inguinal hernia for two years after the surgery, presenting them with self-designed questionnaires just before the surgery, and 2 days, 3 months, 1 year and 2 years after the surgery. The questionnaire contained gradation on a scale from 1 to 10 for the following items: patient preoperative complaints, preferred methods of anesthesia and surgical techniques, intensity of postoperative pain, paraesthesia, physical capacity and general satisfaction with the surgery. The surgical procedure of choice was laparascopic transabdomial pre-peritoneal (TAPP) hernioplasty without mesh fixation. Based on patient’s wishes and medical necessity we also used either Lichtenstein repair (LS) or Shouldice repair (SR). In our Surgical Clinic of the Bethlehem Hospital we operated on 127 adult patients with both uni- and bilateral inguinal hernias between April 2004 and March 2005. 109 patients were enrolled in the study. Out of 109, TAPP were used in 74 cases, Lichtenstein repair in 25 cases, and Shouldice repair in 10 cases. Two days post-op the TAPP group experienced significantly less pain (median of 1 on the pain scale compared to 4 in LS-patients, p < 0.01) than the LS group, requested significantly shorter hospital stay (3 days compared to 5, p = 0.027), and required almost no analgetics (median 0 compared to 5, p < 0.01). 3 month, 1 year and 2 years follow-ups of 108 out 109 patients (99%) revealed no differences between TAPP and LS patients on all the scales but one – numbness was noticed in LS patients more often (p=0.022). Overall physical capacity and satisfaction by surgery was equally high in both groups in all post-op stages (10 on average). Among TAPP patients there were 3 recurrences of hernia (4%), and one among LS-patients (4%). TAPP technique is an excellent procedure, favoured by patients in the immediate post-operative period. The hernia recurrence rates are low in both cases, especially compared to the 2004 Neumayer study. At the same time, the LS-operation remains an important alternative for high-risk patients, or patients not suitable for the TAPP procedure.","abstract_html":"In early 2004, the multi-center study by Neumayer put in question very good results of laparoscopic repair of inguinal hernia, which were achieved in Germany, especially those presented by Bittner and Köckerling. Hence, the idea of this study: we wanted to provide comparative analysis of all current methods available for treatment of inguinal hernias in hospital setting. We aimed to achieve maximum possible coverage to produce reliable patient-centered results, resorting to further investigation in uncertain cases. In this prospective cohort study, we followed patients with inguinal hernia for two years after the surgery, presenting them with self-designed questionnaires just before the surgery, and 2 days, 3 months, 1 year and 2 years after the surgery. The questionnaire contained gradation on a scale from 1 to 10 for the following items: patient preoperative complaints, preferred methods of anesthesia and surgical techniques, intensity of postoperative pain, paraesthesia, physical capacity and general satisfaction with the surgery. The surgical procedure of choice was laparascopic transabdomial pre-peritoneal (TAPP) hernioplasty without mesh fixation. Based on patient’s wishes and medical necessity we also used either Lichtenstein repair (LS) or Shouldice repair (SR). In our Surgical Clinic of the Bethlehem Hospital we operated on 127 adult patients with both uni- and bilateral inguinal hernias between April 2004 and March 2005. 109 patients were enrolled in the study. Out of 109, TAPP were used in 74 cases, Lichtenstein repair in 25 cases, and Shouldice repair in 10 cases. Two days post-op the TAPP group experienced significantly less pain (median of 1 on the pain scale compared to 4 in LS-patients, p &lt; 0.01) than the LS group, requested significantly shorter hospital stay (3 days compared to 5, p = 0.027), and required almost no analgetics (median 0 compared to 5, p &lt; 0.01). 3 month, 1 year and 2 years follow-ups of 108 out 109 patients (99%) revealed no differences between TAPP and LS patients on all the scales but one – numbness was noticed in LS patients more often (p=0.022). Overall physical capacity and satisfaction by surgery was equally high in both groups in all post-op stages (10 on average). Among TAPP patients there were 3 recurrences of hernia (4%), and one among LS-patients (4%). TAPP technique is an excellent procedure, favoured by patients in the immediate post-operative period. The hernia recurrence rates are low in both cases, especially compared to the 2004 Neumayer study. At the same time, the LS-operation remains an important alternative for high-risk patients, or patients not suitable for the TAPP procedure.","abstract_has_math":false,"creators":["Tichomirow, Alexej"],"institution":"Publikationsserver der RWTH Aachen University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Heise, Joachim Wilfried"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2009,"date_issued":"2009","date_published":"2009","updated_at":"2026-07-30T19:40:33Z","subjects":["info:eu-repo/classification/ddc/610","Leistenhernie","Transabdominelle Patchplastik","Bethlehem-Krankenhaus <Stolberg (Rhld.)>","Medizin","Lichtensteinreparation","Shouldice","hernia","repair","TAPP","Lichtenstein"],"languages":["ger"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113493%22"],"render_values":[{"text":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113493%22","href":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113493%22","code":true}]}]},"links":{"outbound_url":"https://publications.rwth-aachen.de/record/51181","outbound_label":"Repository record","outbound_source":"dc:identifier"},"source_record":{"url":"https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A51181","prefix":"oai_dc"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Heise, Joachim Wilfried"]},{"key":"dc:creator","label":"Author","values":["Tichomirow, Alexej"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:coverage","label":"Dc Coverage","values":["DE"]},{"key":"dc:date","label":"Dc Date","values":["2009"]},{"key":"dc:publisher","label":"Institution","values":["Publikationsserver der RWTH Aachen University"]},{"key":"dc:relation","label":"Dc Relation","values":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-28389"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["info:eu-repo/classification/ddc/610","Leistenhernie","Transabdominelle Patchplastik","Bethlehem-Krankenhaus <Stolberg (Rhld.)>","Medizin","Lichtensteinreparation","Shouldice","hernia","repair","TAPP","Lichtenstein"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["ger"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/record/51181","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113493%22"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["In early 2004, the multi-center study by Neumayer put in question very good results of laparoscopic repair of inguinal hernia, which were achieved in Germany, especially those presented by Bittner and Köckerling. Hence, the idea of this study: we wanted to provide comparative analysis of all current methods available for treatment of inguinal hernias in hospital setting. We aimed to achieve maximum possible coverage to produce reliable patient-centered results, resorting to further investigation in uncertain cases. In this prospective cohort study, we followed patients with inguinal hernia for two years after the surgery, presenting them with self-designed questionnaires just before the surgery, and 2 days, 3 months, 1 year and 2 years after the surgery. The questionnaire contained gradation on a scale from 1 to 10 for the following items: patient preoperative complaints, preferred methods of anesthesia and surgical techniques, intensity of postoperative pain, paraesthesia, physical capacity and general satisfaction with the surgery. The surgical procedure of choice was laparascopic transabdomial pre-peritoneal (TAPP) hernioplasty without mesh fixation. Based on patient’s wishes and medical necessity we also used either Lichtenstein repair (LS) or Shouldice repair (SR). In our Surgical Clinic of the Bethlehem Hospital we operated on 127 adult patients with both uni- and bilateral inguinal hernias between April 2004 and March 2005. 109 patients were enrolled in the study. Out of 109, TAPP were used in 74 cases, Lichtenstein repair in 25 cases, and Shouldice repair in 10 cases. Two days post-op the TAPP group experienced significantly less pain (median of 1 on the pain scale compared to 4 in LS-patients, p < 0.01) than the LS group, requested significantly shorter hospital stay (3 days compared to 5, p = 0.027), and required almost no analgetics (median 0 compared to 5, p < 0.01). 3 month, 1 year and 2 years follow-ups of 108 out 109 patients (99%) revealed no differences between TAPP and LS patients on all the scales but one – numbness was noticed in LS patients more often (p=0.022). Overall physical capacity and satisfaction by surgery was equally high in both groups in all post-op stages (10 on average). Among TAPP patients there were 3 recurrences of hernia (4%), and one among LS-patients (4%). TAPP technique is an excellent procedure, favoured by patients in the immediate post-operative period. The hernia recurrence rates are low in both cases, especially compared to the 2004 Neumayer study. At the same time, the LS-operation remains an important alternative for high-risk patients, or patients not suitable for the TAPP procedure."]},{"key":"dc:source","label":"Dc Source","values":["Aachen : Publikationsserver der RWTH Aachen University 75 S. : graph. Darst. (2009). = Aachen, Techn. Hochsch., Diss., 2009"]},{"key":"dc:title","label":"Title","values":["Lichtensteinreparation versus TAPP : prospektive Untersuchung eines Patientenjahrganges am Bethlehem-Krankenhaus über zwei Jahre"]}]}],"canonical_facts":{"dc:contributor":["Heise, Joachim Wilfried"],"dc:coverage":["DE"],"dc:creator":["Tichomirow, Alexej"],"dc:date":["2009"],"dc:description":["In early 2004, the multi-center study by Neumayer put in question very good results of laparoscopic repair of inguinal hernia, which were achieved in Germany, especially those presented by Bittner and Köckerling. Hence, the idea of this study: we wanted to provide comparative analysis of all current methods available for treatment of inguinal hernias in hospital setting. We aimed to achieve maximum possible coverage to produce reliable patient-centered results, resorting to further investigation in uncertain cases. In this prospective cohort study, we followed patients with inguinal hernia for two years after the surgery, presenting them with self-designed questionnaires just before the surgery, and 2 days, 3 months, 1 year and 2 years after the surgery. The questionnaire contained gradation on a scale from 1 to 10 for the following items: patient preoperative complaints, preferred methods of anesthesia and surgical techniques, intensity of postoperative pain, paraesthesia, physical capacity and general satisfaction with the surgery. The surgical procedure of choice was laparascopic transabdomial pre-peritoneal (TAPP) hernioplasty without mesh fixation. Based on patient’s wishes and medical necessity we also used either Lichtenstein repair (LS) or Shouldice repair (SR). In our Surgical Clinic of the Bethlehem Hospital we operated on 127 adult patients with both uni- and bilateral inguinal hernias between April 2004 and March 2005. 109 patients were enrolled in the study. Out of 109, TAPP were used in 74 cases, Lichtenstein repair in 25 cases, and Shouldice repair in 10 cases. Two days post-op the TAPP group experienced significantly less pain (median of 1 on the pain scale compared to 4 in LS-patients, p < 0.01) than the LS group, requested significantly shorter hospital stay (3 days compared to 5, p = 0.027), and required almost no analgetics (median 0 compared to 5, p < 0.01). 3 month, 1 year and 2 years follow-ups of 108 out 109 patients (99%) revealed no differences between TAPP and LS patients on all the scales but one – numbness was noticed in LS patients more often (p=0.022). Overall physical capacity and satisfaction by surgery was equally high in both groups in all post-op stages (10 on average). Among TAPP patients there were 3 recurrences of hernia (4%), and one among LS-patients (4%). TAPP technique is an excellent procedure, favoured by patients in the immediate post-operative period. The hernia recurrence rates are low in both cases, especially compared to the 2004 Neumayer study. At the same time, the LS-operation remains an important alternative for high-risk patients, or patients not suitable for the TAPP procedure."],"dc:identifier":["https://publications.rwth-aachen.de/record/51181","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113493%22"],"dc:language":["ger"],"dc:publisher":["Publikationsserver der RWTH Aachen University"],"dc:relation":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-28389"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Aachen : Publikationsserver der RWTH Aachen University 75 S. : graph. Darst. (2009). = Aachen, Techn. Hochsch., Diss., 2009"],"dc:subject":["info:eu-repo/classification/ddc/610","Leistenhernie","Transabdominelle Patchplastik","Bethlehem-Krankenhaus <Stolberg (Rhld.)>","Medizin","Lichtensteinreparation","Shouldice","hernia","repair","TAPP","Lichtenstein"],"dc:title":["Lichtensteinreparation versus TAPP : prospektive Untersuchung eines Patientenjahrganges am Bethlehem-Krankenhaus über zwei Jahre"],"dc:type":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]},"updated_at":"2026-07-30T19:40:33Z"}