A case for open inguinal hernia repair

Abstract

The open approach to inguinal hernia repair has several distinct advantages in the management of both primary and recurrent groin hernia repairs. A variety of repair techniques are available to suite the patient's condition. Both pure tissue and mesh techniques in a tailored fashion may be employed, rather than the cookie-cutter approach where the mesh is used in the same fashion in every case. Most patients with preexisting comorbidities may have repair carried out under local or regional anesthesia instead of general anesthesia as required by laparoscopy. Studies have demonstrated the efficacy of open preperitoneal mesh placement in the treatment of recurrent inguinal and femoral hernia repair, where hernia recurrence rates, postoperative complications, and long-term patient outcomes are equivalent to laparoscopic repair. The use of robots has yet to demonstrate any advantage over manual repairs either open or laparoscopic, with extended operating time and extreme cost. Return to normal daily activity is advocated in 3–7 days whichever technique is used.