Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice

Abstract

Despite a higher proportion of patients undergoing bilateral repairs, recurrent hernia repair, and concurrent procedures, operative times are shorter for laparoscopic TEP repair than for open mesh repair. TEP repairs can be performed efficiently and without major complications, even when the learning curve is included.

A comparative study between laparoscopic inguinal hernia repair and open inguinal hernia repair

“…5 The incidence of wound infection though slightly higher after OH, was not found to be statistically significant. This was similar to the results of study by Winslow et al 20 Laparoscopic TEP in general had better cosmetic results both subjectively and objectively as similar to earlier observations. 19,23 The postoperative scars were small and hide easily as compared to a relatively longer scar in inguinal region after open repair.…”

“…This may be attributed to reduction in the size of incision, no need of extra or bilateral incisions in case of bilateral hernias, minimal dissection and less handling of cord structures. Same observations was also made by Fujita et al, Winslow et al and Pokorny et al [19][20][21] based on the VAS scores at various hours and the need for additional analgesics.…”

Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Without Mesh Fixation: Report of Early Outcomes

“…The superiority of nonfixation method in terms of avoiding potential nerve damage as well as limiting surgical expenses has been acknowledged. [9,15] Lau et al used fixation method for hernias with a diameter larger than 4 cm where mesh failed to cover hernial defect completely, and found no significant difference when compared to nonfixation method in terms of length of hospital stay, return to normal daily activities, or postoperative morbidity. [16] In their laparoscopic TEP hernia repair study of 172 cases, Khajanchee et al evaluated outcomes of use of fixation in 67 cases and no fixation in 105.…”

Comment to: Outpatient groin hernia repair: assessment of 9330 patients from the French “Club Hernie” database, Drissi F, Jurczak F, Cossa JP, Gillion JF, Baayen C; For “Club Hernie”

“…Shortening the period of hospitalization might be useful for reduction of cost and possible nosocomial infection but it might pose the risk from lack of good post-operative monitoring. There are many determinants for the success of outpatient hernia repair including the skill of surgeon, local facilities of medical center and surgical technique [2]. In our setting in developing countries, due to lack of facilities, the admission of the patients for short hospitalization for closed monitoring of the patient is usually the main option.…”