Complicated Inguinocrural Hernias: Laparoscopic Vs. Open Surgery in the Emergency Setting

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Hernia Repair

Background:

• Laparoscopic treatment for inguinocrural hernias (ICH) is established, but data on its emergency use for incarcerated or strangulated cases is limited.
• Open surgery (OS) is a common approach for complicated ICH.

Purpose of the Study:

• To evaluate the feasibility and safety of laparoscopic surgery (LS) for complicated ICH in emergency settings.
• To compare the outcomes of LS versus OS for incarcerated or strangulated ICH.

Main Methods:

• A retrospective comparative study with a prospective registry of 162 patients with complicated ICH (incarcerated or strangulated) from 2003-2023.
• Patients were divided into open surgery (OS, Lichtenstein technique) and laparoscopic surgery (LS, transabdominal preperitoneal approach) groups.
• Key outcomes including surgical time, length of stay, recurrence, and morbidities were compared.

Main Results:

• LS (79 patients) demonstrated significantly shorter surgical times (70 min vs. 117 min) and reduced length of stay (1.9 days vs. 2.9 days) compared to OS (83 patients).
• Total morbidities were significantly lower in the LS group (6.3%) than in the OS group (16.8%).
• Recurrence rates were similar between LS and OS (1.2% for both).

Conclusions:

• Laparoscopic surgery is a feasible and safe option for treating complicated inguinocrural hernias.
• LS offers advantages over OS, including reduced surgical time, shorter hospital stays, and fewer postoperative morbidities.
• The use of LS for complicated ICH does not lead to an increased rate of recurrence.