Patients' perception of open and endoscopic extraperitoneal inguinal hernioplasty

Most hernia studies have focused on the assessment of clinical outcomes. Few have examined patients' perception of the operative procedures. The present study was undertaken to evaluate the patients' preferred method of repair in those who had personal experience of both endoscopic totally extraperitoneal inguinal hernioplasty (TEP) and open inguinal hernia repair. Qualitative analysis of their choice of method was also examined. Between June 1999 and February 2003, a prospective survey was conducted on 590 patients who underwent TEP at our institution. Previous experience of open inguinal hernia repair was a prerequisite for entry into the study. Patients were interviewed during the first postoperative follow-up to document their preference of TEP or open repair in the event of future recurrence or development of a contralateral inguinal hernia. A total of 121 patients were recruited into the study. Of these, 102 (84.3%) and 11 (9.1%) patients opted for future TEP and open repair respectively. Documented reasons supporting their choice of TEP included less postoperative pain (n = 69), faster recovery (n = 25), shorter incisions (n = 8), early ambulation (n = 5), and others (n = 11). Eight (6.6%) patients had no particular preference. More than 80% of patients, who had experience of TEP and open repair, preferred to undergo TEP. Patients presenting with primary inguinal hernia should be given the options of TEP and open mesh hernioplasty with detailed explanation of advantages and drawbacks of each procedure. Individual preference for the type of surgery should be considered in the management plan of each patient.