Background: Inguinal hernia repair is among the most commonly performed general surgical procedures. While laparoscopic trans-abdominal preperitoneal (TAPP) repair is well established, newer minimally invasive open techniques such as one-inch incision mesh plug repair are gaining interest due to potential advantages in simplicity, reduced operative time, and early recovery.

Objective: To compare the outcomes of one-inch incision mesh plug repair and laparoscopic TAPP repair in the management of primary indirect inguinal hernia with respect to operative time, postoperative pain, complications, and hospital stay.

Methods: This prospective comparative study was conducted in the Department of General Surgery, Major S. D. Singh Medical College, Farrukhabad, Uttar Pradesh, India, from Jan 2017 to December 2017. A total of 60 patients with unilateral primary indirect inguinal hernia were randomly assigned to undergo either open one-inch incision mesh plug repair (Group A, n = 30) or laparoscopic TAPP repair (Group B, n = 30). Operative details, postoperative pain scores, complications, and duration of hospital stay were recorded and analyzed.

Results: The mean operative time was significantly shorter in Group A (38 minutes) compared to Group B (64 minutes). Postoperative pain scores at 24 hours were lower in Group B. However, Group A patients had shorter hospital stays and earlier return to normal activity. Complication rates were comparable between the two groups. No recurrence was observed in either group during the follow-up period.

Conclusion: Both one-inch incision mesh plug repair and laparoscopic TAPP are safe and effective techniques for the repair of primary indirect inguinal hernia. The open approach offers advantages of shorter operative time and faster discharge, while the laparoscopic approach results in less early postoperative pain. Selection of technique should be based on surgeon expertise, patient preference, and available resources.