Minimally Invasive Inguinal Hernia Repair in Elderly Patients Over 70 Years: Postoperative Outcomes and Complications
Related Experiment Video
Updated: Oct 13, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Christiano M P Claus1, João R B Ruggeri2, Victor H S Nezo2
1Department of MIS/Robotics and Abdominal Wall Surgery, Hospital Nossa Senhora das Graças, Curitiba, Brazil.
Background:
Minimally invasive surgery (MIS) for inguinal hernia repair offers postoperative advantages over conventional techniques and is considered the gold standard. As the population ages, concerns regarding comorbidities and anesthetic risks may limit the use of MIS in patients over 70 years.
Objective:
To compare postoperative outcomes after elective MIS inguinal hernia repair between patients aged ≥70 and <70 years.
Methods:
Retrospective analysis of a prospectively maintained database including 200 patients, of whom 57 were elderly (≥70 years). Three of the initial 203 patients were excluded because they underwent open repair: two (<1%) due to anesthetic contraindications associated with age and comorbidities, and one because of a previous radical prostatectomy and pelvic radiotherapy. Outcomes included surgical technique, operative time, hospital stay, postoperative pain assessed using the Numeric Pain Rating Scale (NPRS), and complications (seroma, ecchymosis, and surgical site infection). Assessments were performed immediately after surgery, at 7, 30, and 90 days, and at 6 and 12 months.
Results:
Elderly patients had a longer mean operative time (83.4 ± 56.0 versus 65.7 ± 36.1 minutes; P = .049). However, after excluding associated procedures (n = 183), the difference was no longer significant (71.8 ± 43.6 versus 66.3 ± 35.7 minutes; P = .39). Postoperative complication rates were similar between groups. Elderly patients reported lower NPRS scores both immediately after surgery (0.99 versus 1.4; P = .008) and at 30 days (0.17 versus 0.38; P = .007). Hospital stay was comparable between groups.
Conclusion:
MIS inguinal hernia repair, including laparoscopic and robotic approaches, appears safe and effective in elderly patients, even in the presence of significant comorbidities. Complication rates and hospital stay were comparable between age groups, while elderly patients reported lower postoperative pain scores. Age alone should not be considered a contraindication to minimally invasive inguinal hernia repair.