Abstract Background Inguinal hernia repair is one of the most frequently performed general surgical operations. Laparoscopic approaches (TEP, TAPP) are increasingly used, but direct comparison with open repair, and between laparoscopic subtypes, remains debated. Methods A two-centre retrospective cohort study was undertaken of elective day-case inguinal hernia repairs performed in a single year at a DGH (JPUH) and a GP practice (StS) where there are operating theatres for local anaesthesia cases. Patient demographics, ASA grade, and comorbidities were recorded. Outcomes included complications, readmission, reoperation, and recurrence. Analyses compared open versus laparoscopic repair, primary versus recurrent hernia, and TEP versus TAPP. Results were compared with published benchmarks. Results 386 patients were included (152 JPUH, 234 StS; mean age 59.6 years). Patients at JPUH had higher ASA grades (1.74 versus 1.38, P 0.001). Comorbidity burden was low. Overall, 23 patients (6.0%) experienced a complication, more common at JPUH (9.9 versus 3.4%, P = 0.014). The most frequent complication was chronic pain (2.1%), followed by minor wound issues, bleeding (0.3%), and urinary retention (0.3%). Complications were 8.9% in open repairs versus 4.6% in laparoscopic (P = 0.12). Within laparoscopic cases, TEP (4.8%) and TAPP (4.5%) had equivalent outcomes (P = 1.0). Recurrent hernia repairs carried significantly higher risk (26.1 versus 4.7% complications, P 0.001; 8.7 versus 0.6% recurrence, P = 0.004). Readmission (0.8%) and reoperation (0.5%) were rare. Conclusions Both open and laparoscopic inguinal hernia repairs are safe with low morbidity and recurrence. Laparoscopic subtypes yield equivalent outcomes. Recurrent hernia repair is associated with increased risk and merits particular attention.
Gopaul et al. (Sun,) studied this question.
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