[Laparoscopic repair of secondary lumbar hernias: open vs. laparoscopic surgery. A prospective, nonrandomized study]

Lumbar hernia is an uncommon defect of the posterior abdominal wall and its surgical treatment remains controversial. The aim of the present study was to evaluate the utility of laparoscopy versus open surgery.

We performed a prospective, nonrandomized study of 16 patients with secondary lumbar hernias who underwent surgery between January 1997 and January 2003. Nine patients underwent laparoscopy and 7 underwent open surgery. The variables analyzed were clinical features, hospital data (operating time and length of hospital stay), patient comfort (analgesic consumption and return to normal daily activity) and recurrences. Hospital costs were also analyzed.

No differences were found between the two groups in age or history, although the size of laparoscopically-repaired defects was smaller. Mean operating time, postoperative morbidity, mean length of hospital stay, analgesic consumption, and return to daily activities were significantly lower in the laparoscopic group (P<.01). No statistically significant differences in the cost of the process were found according to surgical approach but significant differences were found in final cost after including the cost of readmissions and recurrences (P<.01).

In our series, the laparoscopic approach was more effective than traditional open surgery in the repair of secondary lumbar hernias while the cost of the two procedures was the same.