To compare the effects of laparoscopic total extra-peritoneal repair (TEP), laparoscopic trans-abdominal pre-peritoneal repair (TAPP) and open inguinal hernia repair on perioperative indexes, postoperative rehabilitation and complications in elderly patients.

A total of 157 elderly patients with inguinal hernia admitted to Tieying Hospital, Fengtai District from April 2015 to December 2019 were selected, and randomly divided into TEP group, TAPP group and open group by throwing method, undergoing TEP, TAPP and open inguinal hernia repair respectively. The perioperative indexes, postoperative complications and recurrence of the two groups were analyzed. The visual analogue scale (VAS) and 36-item short form health survey (SF-36) were used to assess pain and quality of life before and after operation. Venous blood samples were collected before operation and at 12 hours after operation to detect the levels of serum matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1).

The operation time of TEP group was significantly longer than that of TAPP group and the open group (P<0.05). The postoperative exhaust time, postoperative ambulation time, hospital stay, postoperative 24 hours VAS score, MMP-9 and TIMP-1 levels in the open group were significantly higher than those in TEP group and TAPP group (P<0.05), while the hospitalization cost and SF-36 score were lower than those in TEP group and TAPP group (P<0.05). The incidence of postoperative complications in the open group was higher than those in TEP group and TAPP group (P<0.05).

Compared with open inguinal hernia repair, TAPP and TEP have advantages of faster recovery, lower pain, better quality of life and fewer complications, which are of clinical value.