Clinical outcomes of open versus laparoscopic inguinal hernia mesh repair in Palestine: a multicenter retrospective...

Inguinal hernia repair is one of the most frequently performed surgical procedures worldwide, accounting for approximately 75% of abdominal wall hernias, and predominantly occurring in males. Although it is a common procedure with generally favourable outcomes, the postoperative outcomes, such as chronic pain, recurrence, and surgical complications, remain important concerns. The aim of this study was to compare short-term postoperative outcomes and complications between open and laparoscopic inguinal hernia mesh repair.

A retrospective cohort study was conducted to compare the outcomes between open vs. laparoscopic inguinal hernia mesh repair. All patients who underwent inguinal hernia mesh repair in 3 hospitals from 2017 to 2025 were collected. Patients were divided into groups based on surgical technique (open repair vs. laparoscopic repair). Demographic data, operative time, length of hospital stay, postoperative outcomes including surgical complications (hematoma, seroma, surgical site infection, hydrocele, recurrence), and general postoperative complications (urinary retention and postoperative nausea/vomiting) were extracted and analysed. A P-value < 0.05 is considered statistically significant.

A total of 609 patients underwent inguinal hernia repair with mesh. Open repair was more prevalent (77.2%). Reducible and uncomplicated hernias were significantly associated with laparoscopic repair (p < 0.001, p = 0.006), while irreducible and strangulated hernias were predominantly managed with open surgery. Patients undergoing laparoscopic repair were younger (median 51.5 vs. 55 years, p = 0.001) and had shorter operative duration (median 101.5 vs. 113 min, p = 0.001). Urinary retention occurred more frequently after open repair (5.5% vs. 0.7%, p = 0.015), whereas postoperative nausea and vomiting were more common following laparoscopy (2.2% vs. 0.2%, p = 0.039). Overall postoperative complications were low and comparable between the two approaches (12.6% vs. 14.4%, p = 0.572), and early documented recurrence during short-term follow-up was uncommon and did not differ significantly between groups; however, the follow-up duration was insufficient to reliably assess true recurrence rates. (1.1% vs. 1.4%, p = 0.709).

Both open and laparoscopic inguinal hernia repair demonstrated favourable safety profiles in this cohort and were associated with low rates of short-term postoperative complications. However, the short follow-up duration limits assessment of long-term outcomes such as recurrence, chronic postoperative pain, and mesh-related complications.