Page 43 - World Journal of Laparoscopic Surgery

Laparoscopic versus Open Repair of Inguinal Hernia
World Journal of Laparoscopic Surgery, January-April 2008;1(1):41-48
Laparoscopic versus Open Repair of

Inguinal Hernia

Snehal Fegade
Satod, Taluka-Yawal, Dist Jalgaon: Pin: 42530; Maharashtra

Abstract • Cost effectiveness
Background: Despite a large number of clinical studies in recent years • Learning curve.
no consensus has been achieved on the surgical technique of inguinal
hernia repair for various reasons. “Experts” believe that their own MATERIALS AND METHODS
preferred open methods have the lowest possible recurrence and
complication rates. They tend to attribute any negative results, as A literature review was performed using Springer link, BMJ,
shown by a number of regional quality studies, to other surgeons’ Journal of MAS and major general search engines like Google,
poor skill rather than to the technique itself. This review article aimed MSN, and Yahoo, etc. The following search terms were used:
to compare laparoscopic versus open Laparoscopic hernia repair. Laparoscopic inguinal hernia repair, Hernioplasty and
Laparoscopic vs open inguinal hernia repair. 1,600 citations
Keywords: Laparoscopic inguinal hernia repair, Hernioplasty, Inguinal found in total selected papers were screened for further
hernia, Laparoscopic vs open inguinal hernia repair.
references. Criteria for selection of literature were the number of
cases (excluded if less than 20), methods of analysis (statistical
INTRODUCTION
or non statistical), operative procedure (only universally
Repair of inguinal hernia is one of the commonest surgical accepted procedures were selected) and the institution where
procedures worldwide. Irrespective of country, race or the study was done (Specialized institution for laparoscopic
socioeconomic status hernia constitutes a major health-care inguinal hernia repair were given more preference).
drain.
There are three important landmarks in the history of repair of METHOD OF PATIENT SELECTION
inguinal hernia. Anesthetic Consideration
1. Tissue repair Eduardo Bassini 1888 The general anesthesia and the pneumoperitoneum required as
2. Onlay mesh Irving Lichtenstein 1984 (tension-free) repair part of the laparoscopic procedure do increase the risk in certain
3. Laparoscopic Ger, Shultz, hernia repair Corbitt, etc. 1990.
groups of patients. However, procedures requiring only extra
peritoneal insufflation of gas, like total extraperitoneal hernia
AIMS
repair (TEP), may be successfully conducted under regional
The aim of this study was to compare the effectiveness and anesthesia. 1
safety of laparoscopic and conventional open repair in the Most surgeons would not recommend laparoscopic hernia
treatment of inguinal hernia. repair in those with pre-existing disease conditions. Patients
The following parameters were evaluated for both with cardiac diseases and COPD should not be considered as a
laparoscopic and open procedures. good candidate for laparoscopy. The laparoscopic hernia repair
• Method of patient selection may also be more difficult in patients who have had previous
• Operative technique lower abdominal surgery. The elderly may also be at increased
• Operating time risk for complications with general anesthesia combined with
• Intraoperative and postoperative complications pneumoperitoneum.
• Postoperative pain and amount of narcotics used
• Postoperative recovery VARIOUS OPERATIVE TECHNIQUES AVAILABLE
• Recurrence Presently various modalities of treatment are available for repair
• Bilateral assessment and treatment of inguinal hernia.

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