To compare the clinical efficacy of laparoscopic totally extraperitoneal hernia repair (TEP), transabdominal preperitoneal hernia repair (TAPP), and Lichtenstein tension-free repair in the treatment of adult inguinal hernia.

This retrospective cohort study included 135 adult patients with inguinal hernia who underwent treatment at the 985th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from February 2022 to April 2025. According to the surgical approach, the patients were divided into the TEP group, TAPP group, and Lichtenstein group, with 45 patients in each group. Surgery-related indicators, levels of inflammatory factors, incidence of complications, and early recurrence rates were compared among the three groups.

The TEP and TAPP groups were superior to the Lichtenstein group in terms of intraoperative blood loss, operative time, time to ambulation, and length of hospital stay (F=19.234, 6.725, 16.354, and 6.203, respectively; P<0.05). Postoperative levels of the inflammatory factors tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6) increased compared with preoperative levels in all three groups. The increase was most pronounced in the Lichtenstein group and lowest in the TEP group (F=4.215, 3.757, and 4.854, respectively; P<0.05). The overall incidence of complications in the Lichtenstein group was 20.00%, which was significantly higher than that in the TEP group, 4.44%, and the TAPP group, 6.67% (χ²=6.854, P<0.05). There was no statistically significant difference in the early recurrence rate among the three groups (P>0.05).

Compared with Lichtenstein repair, TEP and TAPP have the advantages of less surgical trauma, faster recovery, milder inflammatory response, and fewer complications. However, no significant difference was observed among the three procedures in preventing early recurrence.