Early Postoperative Pain: Open Versus Laparoscopic Unilateral Inguinal Hernia Repair

Abstract

Objective: To compare the early postoperative pain at 24 hours between laparoscopic and open unilateral inguinal hernia repair.

Methodology: Cohort study conducted at the Department of Surgery, Islamabad Medical Complex, Islamabad from 1^st January 2025 to 31^st May 2025. A total of 60 patients with unilateral inguinal hernia were divided equally into laparoscopic and open Lichtenstein repair groups. Postoperative pain was assessed using a Visual Analog Scale (VAS) at 24 hours. Secondary outcomes included operative time, length of hospital stay, postoperative analgesia use and complications based on patient fitness and surgeon discretion.

Results: The median (IQR) VAS pain score at 24 hours was significantly lower in the laparoscopic group [4.0 (3.0–4.0)] than in the open repair group [5.0 (5.0–6.0); p<0.001]. Median (IQR) operative time was longer in the laparoscopic group [46.5 min (45.0–50.0)] than in the open group [31.0 min (27.0–35.0); p<0.005], whereas median (IQR) hospital stay was shorter [1.0 day (1.0–2.0) versus 2.0 days (2.0–3.0); p<0.005]. Additional postoperative analgesia was used by 5 (16.67%) in laparoscopic and 9 (30.0%) in open-repair patients and no postoperative complication occurred in the laparoscopic group, while 1 (3.33%) superficial surgical site infection occurred in the open group. Conclusion: Laparoscopic inguinal hernia repair is associated with significantly reduced early postoperative pain compared to open Lichtenstein repair, despite longer operative times. These findings support the feasibility and patient centered advantages of minimally invasive hernia repair in the local population, highlighting its potential to improve early recovery and postoperative comfort.