Authors' objectives:

The aim of this report is to summarise the available information on conventional versus laparoscopic hernioplasty for the treatment of inguinal hernias.

Authors' results and conclusions: A search on electronic data bases, coverture policies and local data was performed until November 2003. The results obtained from the systematic review carried out by the EU Hernia Trialists Collaboration (EUHTC) of the Cochrane Collaboration were incorporated to this report. Forty one randomized trials that compared laparoscopic hernioplasty vs conventional hernioplasty were selected; a total of 7161 patients were included. Laparoscopic surgery was 14 minutes longer. Surgical complications were rare for both groups, however, they were more frequent in the laparoscopic group, specially in visceral (8 to 2315 vs 1 to 2599 surgeries) and vascular lesions (7 to 2498 vs. 5 to 2758 surgeries). These complications were less common with the TEP (extraperitoneal) procedure than with the TAPP (peritoneal). Hospital stay was similar, but return to daily activities was faster in the laparoscopic group (7 days before). Less pain and discomfort were observed with laparoscopic surgery. The use of prosthetic mesh in laparoscopic surgery reduces recurrence in comparison with open surgery without mesh, but the rate of recurrence is similar if the mesh is used in both procedures.

Authors' recommendations: Because the results of both procedures are similar, except for a faster return to work, laparoscopic hernioplasty requires more training and experience and is more expensive. The recommendations for the treatment of inguinal hernia at present are: - Conventional surgery with mesh is recommended for the treatment of primary inguinal hernias. - Laparoscopic surgery is recommended for the treatment of recurrent or bilateral hernias. When the laparoscopic procedure is performed, the extraperitoneal procedure(TEP) is preferred. Laparoscopic hernioplasty should only be performed by experienced and adequately trained surgical teams who usually perform this procedure.

Authors' methods: Economic evaluation

Project Status: Completed

URL for project: http://www.iecs.org.ar/

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)