Standard Hernia Surgery Works Best in Men
Laparoscopic Hernia Surgery May Increase Risk of Complications
WebMD News Archive
Laparoscopic vs. Conventional Hernia Surgery continued...
Researchers found complications during and immediately after
surgery as well as potentially life-threatening complications occurred
significantly more frequently in the laparoscopic group than in the open group.
But rates of long-term complications were similar between the two groups.
Men who had open surgery reported more pain in the two weeks
following surgery than those in the laparoscopic group, but by three months
after surgery reported pain levels were similar in both groups.
Other findings of the study include:
Men who had laparoscopic hernia surgery returned to normal activities one
day earlier than those who had open surgery.
- Time to return to sexual activity was similar in the two groups.
- More men in the laparoscopic group were able to perform specific
activities, such as climbing stairs, shoveling, or weight lifting, at two weeks
after the procedure, but differences in activity level function between the
groups disappeared after three months of follow-up.
- Both groups had improved function at three months after surgery compared to
before the procedure, and there were no differences in improvement scores after
Based on the results of their study, the researchers conclude
that for first-time hernias, the standard, open technique of surgical repair
"is superior to the laparoscopic technique, both in terms of recurrence
rates and in terms of safety."
More Not Necessarily Better
In an editorial that accompanies the study, Danny O. Jacobs,
MD, MPH, of Duke University Medical Center, says these findings show that most
general surgeons can achieve excellent results using conventional hernia
surgery techniques under local anesthesia.
"They also remind us that substantive short-term and
long-term complications may occur, even after 'simple' hernia surgery,"
But he says the study also raises many important questions
about how the surgeon's and other hospital employees' experience with hernia
surgery affects how well the patient does.
"The relationship between the volume of procedures
performed and the outcomes is not straightforward," writes Jacobs. "It
is apparent that some hospitals that do few hernia surgeries have good outcomes
and some hospitals that do many hernia surgeries have relatively poor
outcomes," he explains.