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Home E-Weekly April 2, 2013

How Do Lap and Open Hernia Repair Compare?

Published: April 1, 2013

While the recurrence rates of laparoscopic and open hernia repair surgeries are roughly the same, blood loss is lower in the laparoscopic approach and complication rates are lower in open procedures, according to a study published in JAMA Surgery.

Researchers randomized 206 patients with incisional hernias between 3cm and 15cm from 10 hospitals to either laparoscopic or open mesh repair, in order to compare the 2 approaches. Laparoscopic patients lost significantly less blood (10ml versus 50ml in open procedures), and just 3% needed wound drains, compared with 45% of open patients.

However, laparoscopic procedures were longer by an average of 24 minutes (100 versus 76 minutes) and resulted in a higher rate of complications (9% to the open approach's 2%). Pain and nausea scores did not differ significantly, and recurrence rates were comparable (14% in the open group, 18% in laparoscopic).

"The size of the defect was found to be an independent factor for recurrence of an incisional hernia," write the authors. "Based on this large randomized clinical trial, laparoscopic incisional hernia repair is an effective technique with recurrence rates comparable with open repair."

Stephanie Wasek

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