Standard Hernia Surgery Works Best in Men
Laparoscopic Hernia Surgery May Increase Risk of Complications
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 two years.
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," writes Jacobs.
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.