Predictors of laparoscopic versus open inguinal hernia repair

Pavlosky, K. Keano; Vossler, John D.; Murayama, Sarah M.; Moucharite, Marilyn; Murayama, Kenric M.; Mikami, Dean J.

doi:10.1007/s00464-018-6557-6

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…One study observed that younger age was a predictive factor toward laparoscopic approach, along with gender, race, insurance type, as well as surgeon annual volume, hospital size, and hospital region. 11 There were two interesting observations in our study regarding postoperative seromas and early postoperative pain. There was a significant difference during triple-arm analysis of postoperative seromas between all three groups that was not statistically significant on further pairwise analysis.…”

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

“…The American Surgeon™ 89 (11) Cost analysis of the four repair types demonstrated that robotic repair is most expensive with an average cost of $19,614. TEP and TAPP repairs are next with average costs of $13,374 and $12,931, respectively.…”

mentioning

confidence: 99%

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Comparison of Robotic, Laparoscopic, and Open Unilateral Repair of Non-recurrent Inguinal Hernia

Hsu

Kelley

Zambito

et al. 2022

The American Surgeon™

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Background There is a paucity of data comparing open, robotic, and laparoscopic approaches on unilateral, non-recurrent inguinal hernias. Our study presents a large, retrospective triple-arm outcome analysis between robotic, laparoscopic, and open unilateral, non-recurrent inguinal hernia repairs at a single institution. Methods 706 patients who underwent elective, non-recurrent inguinal hernia repair performed by 8 general surgeons at a single institution from 2016 to 2019 were reviewed retrospectively. Patient baseline characteristics, operative times, resident involvement, and postoperative outcomes were analyzed for all repair types. A cost analysis of the different procedures was performed. Results There were 305 laparoscopic repairs, 207 robotic repairs, and 194 open repairs. Open and laparoscopic repairs were performed on patients who were older (p =< .001) and with a higher Charlson Comorbidity Index (p =< .001). Patient BMI was higher in minimally invasive repair than open repair (P = .021). There were no significant differences in complication rates on pairwise analysis. Robotic and open repairs had significantly longer operative times than laparoscopic repairs (P < .001). There was less resident involvement in robotic repair than with the other approaches (P < .001). Resident involvement was associated with shorter OR times (P = .001) and no significant difference in postoperative complications. There was a trend over the study period toward faster operative times and more robotic repair. Robotic repair is the most expensive repair, followed by laparoscopic and open repairs. Conclusion All 3 repair techniques can be performed without significant differences in outcomes. The technique utilized should be based on surgeon preference and patient characteristics.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Comparison of Robotic, Laparoscopic, and Open Unilateral Repair of Non-recurrent Inguinal Hernia

Hsu

Kelley

Zambito

et al. 2022

The American Surgeon™

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“…Surgical repair is the primary treatment for inguinal hernia and is one of the most common procedures in general surgery 1,2 . Although open inguinal hernia repair (OIHR) was the standard surgery for inguinal hernia, laparoscopic inguinal hernia repair (LIHR), which was developed in 1990, has become more popular; a retrospective study in the US reported that the rate of LIHR increased from 24.2% to 34.8% between 2010 and 2015 3–6 . Various studies have reported the advantages of LIHR, such as reduced postoperative pain, fewer complications including hematoma and nerve damage, and a lesser rate of chronic pain, compared with OIHR 7–15 .…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Although open inguinal hernia repair (OIHR) was the standard surgery for inguinal hernia, laparoscopic inguinal hernia repair (LIHR), which was developed in 1990, has become more popular; a retrospective study in the US reported that the rate of LIHR increased from 24.2% to 34.8% between 2010 and 2015. [3][4][5][6] Various studies have reported the advantages of LIHR, such as reduced postoperative pain, fewer complications including hematoma and nerve damage, and a lesser rate of chronic pain, compared with OIHR. [7][8][9][10][11][12][13][14][15] The postoperative recurrence rate following LIHR is reported to be nearly equivalent to that following OIHR.…”

Section: Introductionmentioning

confidence: 99%

Comparison of laparoscopic and open inguinal hernia repair in adults: A retrospective cohort study using a medical claims database

Yoneyama

Nakashima

Takeuchi

et al. 2022

Asian J Endoscop Surgery

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Introduction: This study aimed to investigate and compare the surgical complications following laparoscopic inguinal hernia repair (LIHR) with those following open inguinal hernia repair (OIHR). Methods: This was a retrospective cohort study based on nationwide claims data. We extracted the data of patients aged ≥20 years who underwent inguinal hernia repair (IHR) between 2009 and 2020. The primary outcome was postoperative complications of IHR, and the secondary outcomes were recurrence of hernia and length of hospital stay. Patient characteristics were adjusted with propensity score (PS) matching, the annual proportions of LIHR versus OIHR were summarized, and the surgical outcomes of each IHR were analyzed. Results: Of the 15 728 eligible patients, 6512 underwent LIHR. The proportion of LIHR increased from 14.7% to 52.8% annually during the study period. From the analysis of 6060 pairs created by PS matching, the risk of surgical site infection (odds ratio [OR] 0.70; 95% confidence interval [CI] 0.56-0.86; P = .0007), and acute postoperative pain (OR 0.69; 95% CI 0.60-0.79; P < .0001), and chronic postoperative pain (OR 0.83; 95% CI 0.70-0.98; P = .0291) were significantly lower with LIHR than with OIHR. The recurrent rate was not significantly different between the LIHR and OIHR groups (OR, 0.68; 95% CI 0.45-1.01; P = .0558). Furthermore, no significant difference was found in the length of hospital stay between the LIHR and OIHR groups (2.91 ± 1.94 days vs 2.97 ± 2.61 days, difference ± SE: 0.06 ± 0.04, P = .1307). Conclusion:LIHR might be superior to OIHR in terms of fewer surgical complications and might be preferred over OIHR in the future.

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