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Research Highlights
Open Surgery Beats Laparoscopy for Most Hernia Repairs
April 1, 2004
A VA study of nearly 1,700 hernia-repair operations found fewer recurrences and complications
overall with open surgery than with laparoscopic surgery. The researchers analyzed 834 open and
862 laparoscopic surgeries performed at 14 VA medical centers 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 study found that surgeons' experience mattered far more in
laparoscopy: For the surgeons in the study who reported having done more than 250 laparoscopic
repairs, the recurrence rate was below 5 percent-similar to the rate for open repairs. However,
the figure was consistently above 10 percent for surgeons reporting less experience with the
procedure. Open surgery was far less experience-dependent. Laparoscopy 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.
Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W; Veterans Affairs Cooperative Studies Program 456 Investigators.
Open mesh versus laparoscopic mesh repair of inguinal hernia.
N Engl J Med. 2004 Apr 29;350(18):1819-27. Epub 2004 Apr 25.
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