Inguinal Herniorrhaphy: Complications and Recurrences

Because laparoscopic surgical techniques have been applied to inguinal hernia repair, the surgeon has been forced to re-evaluate his particular open technique and its resultant complications and recurrences to determine what is the best procedure for patients. In this article, complication rates for open inguinal herniorrhaphy varied from 7% to 12% with some reports as low as 1% using the anterior mesh technique. The most frequent complications were wound problems and scrotal and testicular swelling. In the laparoscopic series using retroperitoneal mesh or the "onlay" technique, the number of complications in 3,288 inguinal herniorrhaphies was 522 (16.8%). On the other hand, recurrence rates for open inguinal herniorrhaphy ranged from 1% to 10% for primary repair to as high as 35% for the repair of recurrent hernias. The laparoscopic series involved 3,178 repairs using the retroperitoneal and onlay techniques, and 61 recurrences (1.92%) were noted in a follow-up greater than 6 months. These data emphasize that complication and recurrence rates are similar between open and laparoscopic inguinal herniorrhaphy.