“Complications are known to occur at each and every step of hernia surgery. Applying caution while performing each step can save the patient from a lot of morbidity. One starts by applying strict patient selection criteria for endoscopic hernia repair, especially in the initial part of ones learning curve. A thorough knowledge of anatomy goes a long way in avoiding most of the complications seen in hernia repair. This anatomy needs to be relearned from what one is used to, as the approach is totally different from an open hernia repair. And finally, learning and mastering the right technique is an essential prerequisite before one ventures into inguinal hernia repair.”

“The most important preoperative precaution is proper patient selection prior to surgery, especially in the initial part of the learning curve. Ideally, direct or small indirect hernias are best. Large hernias, obese patients and irreducible, obstructed hernias are best avoided. An absolute contraindication is strangulated hernia. Also a detailed work-up of elderly patients to assess cardiorespiratory status is mandatory to ensure a safe outcome.”

“Endoscopic hernia repair is a technique that is to soon become an important part of the armamentarium of a hernia surgeon. Although the initial reported incidence of complications following laparoscopic hernia repair was higher, it has fallen following the standardization of the technique. Felix et al found a complication rate of 6% over a 6-year period but when it was broken down into two 3-year periods, their rate was 3.6% in the first 3 years and dropped to 0.5% in the following 3 years.”

Chowbey PK, et al. Complications in groin hernia surgery and the way out. J Minim Access Surg. 2006 Sep;2(3):174-7. Free Full Text