Open Mesh Vs. Lap Mesh Repair of Inguinal Hernia

Bullen NL, Massey LH, Antoniou SA, Smart NJ, Fortelny RH. Open versus laparoscopic mesh repair of primary unilateral uncomplicated inguinal hernia: a systematic review with meta-analysis and trial sequential analysis. Hernia. 2019; 23(3):461–472.

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RESULTS: This study included 12 randomised controlled trials with 3966 patients randomised to Lichtenstein repair (n = 1926) or laparoscopic repair (n = 2040). There were no significant differences in recurrence rates between the laparoscopic and open groups (odds ratio (OR) 1.14, 95% CI 0.51-2.55, p = 0.76). Laparoscopic repair was associated with reduced rate of acute pain compared to open repair (mean difference 1.19, CI - 1.86, - 0.51, p ≤ 0.0006) and reduced odds of chronic pain compared to open (OR 0.41, CI 0.30-0.56, p ≤ 0.00001). The included trials were, however, of variable methodological quality. Trial sequential analysis reported that further studies are unlikely to demonstrate a statistically significant difference between the two techniques.


Li J, Ji Z, Li Y. Comparison of laparoscopic versus open procedure in the treatment of recurrent inguinal hernia: a meta-analysis of the results. Am J Surg. 2014;207(4):602–612.

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“A total of 1,311 patients enrolled into 6 randomized controlled trials and 5 comparative studies were included in this meta-analysis. Our pooled data showed that the laparoscopic procedure was associated with a lower incidence of wound infection and a shorter sick leave. However, there were no differences in other complication rates or the operation time between the 2 methods.”


Neumayer L, Giobbie-Hurder A, Jonasson O, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004;350(18):1819–1827.

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NEJM Open vs Lap Repair_Inguinal HerniasTable 2. Characteristics of the Repair Procedures, Postoperative Complications, and Recurrences at Two Years.


More PubMed results on open vs lap repair of inguinal hernias.

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