Outcomes from Early Experience with Laparoscopic Inguinal Hernia Repair Versus Open Technique: Navigating the Learning Curve

Abstract

Objectives: The current consensus in literature often suggests laparoscopic inguinal hernia repair (LIHR) as superior to open inguinal hernia repair (OIHR) regarding postoperative pain, recurrence rates, duration of hospital stay, and other postoperative outcomes. Our study aimed to evaluate these outcomes within the context of our centre in its initial experience of laparoscopic repairs. Methods: We performed a single-centre, retrospective observational study encompassing all patients who underwent elective OIHR and LIHR from January 2011 through September 2020. This comprised 2690 and 158 cases respectively. examining parameters like demographic data, comorbidities, hernia type, mesh characteristics, surgery duration, hospital stay, and immediate postoperative complications. Results: The demographic profiles, hospital stay, and complication rates were similar in both groups. However, surgical site infection was present exclusively in the OIHR group (3.5% vs. 0.0%; p<0.05). The timeline for returning to normal activities was statistically shorter for the LIHR group [6 days vs. 8 days; p <0.05]. The most frequent immediate complication in the LIHR group was subcutaneous emphysema [46.67%; p<0.05]. Recurrence [9.23% vs. 3.6%; p=0.09] and chronic pain [41.5% vs. 13.6%; p<0.05] were higher in the LIHR group. Conclusion: In the course of our early experience with LIHR, we observed lower recurrence and chronic pain rates with OIHR. However, LIHR had significant advantages with respect to faster patient recovery and lower rates of SSI. While our results contribute an interesting deviation from the standard narrative, they should be interpreted within the context of a learning curve associated with our early experience with LIHR.

Keywords: Hernia; Hernia, Inguinal; Laparoscopy.