In the world of #inguinal #hernia #surgery, the biggest debate over the past two decades has focused on the preferred approach. The "open" technique involves an incision over the groin to fix the hernia and place mesh to prevent its recurrence. The more novel #laparoscopic techniques uses three small incisions higher up on the abdomen to dissect the same anatomy and place mesh from below. While the laparoscopic approaches, unsurprisingly, have always had the benefit of reduced pain and a quicker return to activity, a slow learning curve and evolutions in technology have been implicated in a higher recurrence rate than the open approach. Until now, that is...
A recent large-volume meta-analysis published in the World Journal of Hernia and Abdominal Wall Surgery analyzed the rates of recurrence as well as short- and long-term pain. It found that not only was short-term and chronic #pain significantly lower following laparoscopic repair, but recurrence rates were no different between the two techniques. This finding will need to be confirmed in future studies to fully sway the vast majority of hernia surgeons who default to the open repair. But as a minimally invasive and #robotic surgeon, I am heartened that this study confirms what I have long believed -- that the laparoscopic approach is the best approach for most patients.
