Our Summary

This study looked at whether open surgery or keyhole surgery (laparoscopy) is better for fixing umbilical and epigastric hernias that are larger than 1 cm. The researchers used data from the Danish Hernia Database and the National Patient Registry from 2007 to 2018 to understand post-surgery complications, readmission to the hospital within 90 days, repeat surgeries due to complications, and long-term need for additional surgeries due to the hernia coming back.

The study included 6855 patients, 59.9% of whom had open surgery and 40.1% had keyhole surgery. The researchers found that more patients who had open surgery had to be readmitted due to infection at the surgery site (2.5%) compared to those who had keyhole surgery (0.5%). Similarly, the rate of repeat surgery due to complications within 90 days was higher for open surgery (5.0%) compared to keyhole surgery (2.7%).

However, the researchers also found that the chance of needing a repeat surgery due to a severe complication was higher after keyhole surgery (1.5%) compared to open surgery (0.8%). The likelihood of needing another surgery because the hernia came back was nearly the same for both types of surgery (3.5% for open surgery and 4.2% for keyhole surgery).

In conclusion, while the rates of hernia recurrence were similar for both types of surgery, open surgery was linked with a higher rate of readmission and repeat surgery due to infection. However, the chance of needing a repeat surgery due to a severe complication was higher after keyhole surgery.

FAQs

  1. What types of hernia surgeries were compared in this study?
  2. What were the findings regarding post-surgery complications and readmission rates for open surgery versus keyhole surgery for hernia repair?
  3. Was there a difference in the likelihood of needing another surgery due to hernia recurrence between open surgery and keyhole surgery?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about laparoscopic hernia repair is to be aware of the potential risks and benefits associated with both open and keyhole surgery. It is important to discuss these options with your surgeon and weigh the pros and cons based on your individual circumstances and health history. Additionally, make sure to follow post-operative care instructions closely to reduce the risk of complications and enhance the success of the surgery.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair are those with umbilical and epigastric hernias larger than 1 cm. This study suggests that laparoscopic surgery may be preferred for these types of hernias due to lower rates of post-surgery complications and readmission for infection compared to open surgery. However, patients should be aware of the higher risk of needing a repeat surgery due to severe complications after laparoscopic surgery. Ultimately, the decision of which type of surgery to undergo should be made in consultation with a healthcare provider based on individual factors and preferences.

Timeline

Before laparoscopic hernia repair, the patient may experience symptoms such as pain or discomfort at the site of the hernia, a visible bulge or swelling, and potential complications such as incarceration or strangulation of the hernia. The patient may undergo imaging tests such as ultrasound or CT scan to confirm the diagnosis.

After laparoscopic hernia repair, the patient can expect a shorter hospital stay, less post-operative pain, quicker recovery time, and a lower risk of infection compared to open surgery. However, there may be a slightly higher risk of needing repeat surgery due to severe complications after laparoscopic hernia repair. The patient will also need to follow post-operative instructions such as avoiding heavy lifting and strenuous activities to ensure proper healing. Regular follow-up appointments may be necessary to monitor the healing process and check for any signs of hernia recurrence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hernia repair include:

  1. What are the potential risks and complications associated with laparoscopic hernia repair compared to open surgery?
  2. How long is the recovery period expected to be for laparoscopic hernia repair?
  3. Will I have any restrictions or limitations on physical activity following the surgery?
  4. How likely is it that the hernia may come back after laparoscopic hernia repair?
  5. What is the success rate of laparoscopic hernia repair in terms of long-term outcomes?
  6. What are the potential benefits of laparoscopic hernia repair over open surgery?
  7. How experienced are you in performing laparoscopic hernia repair procedures?
  8. Are there any specific factors about my hernia that may make me a better candidate for laparoscopic surgery versus open surgery?
  9. How will post-operative care and follow-up appointments be handled after laparoscopic hernia repair?
  10. Are there any additional considerations or information I should be aware of before deciding on laparoscopic hernia repair as my treatment option?

Reference

Authors: Henriksen NA, Jorgensen LN, Friis-Andersen H, Helgstrand F; Danish Hernia Database. Journal: Surg Endosc. 2022 Jan;36(1):526-532. doi: 10.1007/s00464-021-08312-5. Epub 2021 Feb 2. PMID: 33528663