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Prospective comparison between laparoscopic preperitoneal herniorrhaphy and open mesh herniorrhaphy
J R Smith1, M L Demers, R Pollack
1Orlando Regional Medical Center, Florida, USA.
The American Surgeon
|March 13, 2001
Summary
Open mesh herniorrhaphy (OH) is more cost-effective than laparoscopic herniorrhaphy (LH), despite similar satisfaction rates. Laparoscopic repair offers a faster recovery, but with a higher complication rate and cost.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
Background:
- The optimal surgical approach for inguinal hernia repair remains debated.
- Laparoscopic herniorrhaphy (LH) and open mesh herniorrhaphy (OH) are common procedures with distinct characteristics.
Purpose of the Study:
- To compare complications, costs, patient satisfaction, and recovery times between LH and OH.
- To provide data to inform the choice of surgical technique for inguinal hernias.
Main Methods:
- A prospective, nonrandomized analysis of 233 consecutive inguinal hernia repairs performed by 27 surgeons.
- Data collected on complications, costs (anesthesia/OR time, hospital charges), patient satisfaction, and recovery via third-party interviews.
Main Results:
- Laparoscopic herniorrhaphy (LH) incurred an average additional cost of $2254 per case compared to open mesh herniorrhaphy (OH).
- Complication rates were 4.4% for OH and 8.3% for LH, with all complications being minor and no recurrences noted in either group.
- Patient satisfaction and pain indices were comparable, while LH demonstrated a shorter recovery time by 5.5 days.
Conclusions:
- Open mesh herniorrhaphy (OH) is associated with a lower complication rate and reduced cost compared to laparoscopic herniorrhaphy (LH).
- While pain and satisfaction are similar, LH offers a significantly faster recovery period.