Laparoscopic hernia repair in Singapore--views from a cross-section of surgeons

Laparoscopic cholecystectomy was introduced into Singapore in 1990, and has since replaced conventional cholecystectomy as the treatment of choice for gallstone disease in most situations. In contrast, laparoscopic hernia repair introduced two years later in the same wave of enthusiasm, was received with scepticism and much less acceptance. A survey of 27 general surgeons in three large institutions in Singapore was performed to analyse this observation. The majority of surgeons felt that laparoscopic hernia repair (i) had limited applications, mainly for bilateral and recurrent hernias, (ii) was not completely established as a technique, requiring refinement in the procedure, (iii) was costly, and (iv) did not have objective evidence of long-term benefits over conventional hernia repair.