Background: Groin hernia in adults remains a common condition in digestive surgery. Numerous repair techniques have been described, with two methods widely adopted for the surgical treatment of inguinal hernia: the Lichtenstein open repair technique and the totallyextraperitoneal (TEP) laparoscopy.

Objective: This study aims to compare the outcomes of these two methods, focusing primarily on post operative complications, recovery time, and incidence of recurrence.

Materials and Methods: We conducted a prospective, randomized, double-blind comparative study of two methods for repairinguncomplicated inguinal hernias. The study population was mainly composed of young active military personnel, over an 18-month period(June 2021 to December 2022) in the general surgery department of the regional military university hospital in Constantine. One hundredpatients undergoing outpatient surgery for uncomplicated inguinal hernia were divided into two homogeneous groups: Group A (TEP) andGroup B (Lichtenstein). Evaluation criteria included operating time, postoperative pain, recovery time and return to normal activities,complication rate, and recurrence rate.

Results: All patients were male, with a mean age of 33.09 years. Herniogenic factors were dominated by physical exertion (83% of cases). Theright-sided hernia was observed in 66% of cases, and 99% of patients were classified ASA I. The mean duration of the surgical procedure was51.44 minutes (64,5 vs 48,5). Twenty-nine patients experienced immediate post-operative pain (50% vs. 18%, p < 0.111). However, on postoperative day 15, pain was more frequent in patients in the open surgical repair group (14% vs. 90%, p < 0.444). Forty-seven patients experienced post-operative nausea and vomiting (64% vs. 30%, p ≈ 0.26). Chronic pain at three months post-operatively was reported by three patients (6%) in the Lichtenstein group (p ≈ 0.079). Fifteen patients (30%) in the first group resumed physical activity from the third postoperative day, and 94% of patients in this group resumed physical activity by the seventh day. In contrast, 44 patients (88%) in the second group resumed their physical activities from day five onwards (p < 0.444). After 29 days off work, 81 patients returned to work (20.68 days vs. 32.7 days). Only one recurrence was observed in a patient operated on by TEP (2% vs. 0%, p ≈ 0.315). The overall satisfaction rate was 87% (92% vs. 82%, p ≈ 0.012).

Conclusion: The objectives of inguinal hernia repair are to provide patients with a better quality of life by reducing post-operative pain, enabling rapid rehabilitation and return to work, while minimizing the risk of recurrence. This involves improving repair techniques and the prosthetic materials used.