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Why Laparoscopic Inguinal Hernia Repair Is Better Than Open Repair


Does it matter whether your inguinal hernia is repaired Laparoscopically or with a conventional Open Repair? YES, it absolutely does. Many surgeons, who do NOT perform the laparoscopic repair, will tell you that it does not matter, or that the open repair is better. This, in our opinion, a group that has performed over 3000 laparoscopic repairs over the last decade, is definitely incorrect. From 2008-2011 we reviewed our data, and here is what we found.

First, the Laparoscopic Inguinal Hernia Repair is safe. Our internal review documented a 0.3% complication rate. Studies of open repair over the last several decades have documented complication rates between 5 and 20%. Although the original studies observed higher complication rates with the laparoscopic repair, we feel strongly, and prove with our internal data, that like any new procedure and technology, there is a learning curve. Once the surgeon has performed several hundred repairs, the complication rates plummet. We have performed thousands of repairs.

Second, the Laparoscopic Repair makes much smaller incisions into the fascia. In fact, the largest incision in any fascial plane is only 1 cm. There is literally no other tissue damage whatsoever. The planes between the muscle and fascia are then gently dissected apart with the help of low pressure gas, which quickly dissolves after the case. Once the repair is complete, the planes are allowed to come back together as the gas is removed. The outcome of this method allows patients to return to their lives quickly and safely, and the post-operative pain levels are vastly less than the open repair.

Third, hernia surgery is not forever. More specifically, the Recurrence Rate means whether or not the hernia comes back over the course of your lifetime. Open hernia repair has been documented to be between 2 and 10% (even higher in other studies). In our study, the recurrence rate is 0.4%. That means that in the best documented open hernia recurrence data, our laparoscopic repair is still 4 times LESS LIKELY to have a recurrence! Why? The answer is simple: the laparoscopic repair is a mechanically superior, more architecturally sound repair. It stands to reason that it will hold up better over time.

So why do some surgeons tell their patients that open inguinal hernia surgery is just as good? Better? The truth is that in their hands, it might be better. The average General Surgeon, currently in their prime, was not trained to do the laparoscopic hernia repair, and therefore, they never learned it, and do not feel comfortable doing it. The critical point, however, is this: if you have an inguinal hernia, and desire a laparoscopic repair (which you should because it is better), then you must go to a surgeon who does this repair. Lots of them. Several times a week.