The researchers analyzed 834 open and 862 laparoscopic surgeries performed at 14 VA medical centers between 1999 and 2001 to repair inguinal, or groin, hernias, the most common type. In two years of follow-up, the laparoscopic group had a 10-percent recurrence rate and 39-percent complication rate, compared to about 5 percent and 33 percent for the open-surgery group. The laparoscopic patients were more active and had less pain in the two weeks after the operation, but these factors leveled off for the two groups within three months.
"Based on these findings, we'd recommend that men with a hernia that has never been repaired before should undergo an open repair," said study leader Leigh Neumayer, MD, of the Salt Lake City VA Medical Center and University of Utah. She noted that for recurrent hernias--which account for about 10 percent of groin hernias--the numbers in the study were too small to make recommendations.
Laparoscopic surgery uses pencil-thin tubes fitted with cutting tools and miniature cameras that enable the surgeon to see inside the abdomen or pelvis. The procedure uses a few tiny cuts; open surgery requires a single incision about three inches long. Laparoscopy is a more intricate procedure but is associated with less pain and faster recovery for patients.
Today it is widely used for gallbladder repair and some other operations. But it has not become the overwhelming procedure of choice for hernias. "This may be because open hernia repair is a common procedure with excellent results that is already done on an outpatient basis without many complic
Contact: Susan Huff
VA Research Communications Service