Laparoscopic herniorrhaphy

Laparoscopic herniorrhaphy is performed transabdominally. It has less to commend it - in contrast to other laparoscopic procedures - relative to more traditional procedures: open herniorrhapy is already performed on an outpatient basis with little long-term recurrence.

However, laparoscopic herniorrhaphy is thought to offer the following advantages:

• less postoperative pain, both acutely and more chronically due to a reduced incidence of neuromata
• less chance of spermatic cord or testicular injury
• less risk of postoperative orchitis and hence testicular atrophy
• a shortened convalescence period
• more rapid return of postoperative activity

There is little consensus as to the long-term benefit of laparoscopic herniorrhaphy: there are few studies.

NICE guidance states that for the repair of primary inguinal hernia, open (mesh) should be considered the preferred surgical procedure. However for the repair of recurrent and bilateral inguinal hernia, laparoscopic surgery should be considered (1).

Reference:

• 1) NICE (April 2001). Summary of Guidance issued to the NSH in England and Wales, Laparoscopic surgery for inguinal hernia, 2, 22.