Patient perception of laparoscopic versus open mesh repair of inguinal hernia, the hard sell

Abstract

The results show that many patients have an incorrect perception of laparoscopic inguinal hernia repair, which may reflect an inadequate consent and counselling process. No definitive evidence exists regarding the superior safety and efficacy of one method over another, but it would appear that a significant number of patients are unaware of this.

Inguinal hernia repair with Parietex ProGrip mesh causes minimal discomfort and allows early return to normal activities

“…In experienced hands, laparoscopic inguinal hernia repair is also safe although unquestionably associated with a higher risk of rare but "serious" complications, and even death following an elective operation [26,28]. Furthermore, it is evident that patient perceptions of the pros and cons of open and laparoscopic methods are often incorrect suggesting an inadequate consent and information process by the treating surgeon [32]. In relation to long-term problems, patients offered the laparoscopic approach are not routinely warned about the risk of scarring from placement of mesh in the pelvis which might compromise future oncological surgery [33][34][35].…”

Litigation claims following laparoscopic and open inguinal hernia repairs

“…Even when complications have been discussed and documented, patient recalling and understanding can be affected [18]. Notably patients misunderstand the relative risks and benefits of laparoscopic versus open IHR even after counselling [19]. Furthermore, one study has shown that there are inconsistencies between documentation and what is actually discussed with the patient [20].…”

What is the Real Fair Study Model to Compare Open and Laparoscopic Mesh Repairs for Unilateral Inguinal Hernia Regarding Postoperative Pain and Discomfort?

“…Another interesting finding in Patel et al's study is that most patients arrive at an outpatient appointment without a preferred method and possibly directed to laparoscopic repair, reflecting surgical practice of the institution [10]. Most surgeons have their own strong views and preferences over one repair technique, and can convince their patients in favor of an approach.…”

“…Generally, surgeons tell their patients that ELR's are less invasive and related with less pain and quicker recovery. In a very recent questionnaire study about the patient perception of laparoscopic versus open mesh repairs, it was revealed that many patients had incorrect perceptions, a large number were under the false impression that laparoscopic techniques were safer, quicker and less likely to recurrence over open repair [10]. Besides, many patients felt that laparoscopic repair was the only method which could be undertaken as a day case procedure.…”