A COMPARISON OF LAPAROSCOPIC AND OPEN HERNIA REPAIR AS A DAY SURGICAL-PROCEDURE

To evaluate the merits of laparoscopic inguinal hernia repair (LHR) co mpared to conventional open hernia repair (OHR) a randomized study has been conducted.All patients were day surgical cases, of which 44 were randomized to a standardized OHR under local anesthetic (LA) and 42 t o an LHR under general anesthesia (GA). Fifteen LHR patients had bilat eral repairs. Operative time for OHR was 30.5 min, for unilateral LHR 35 min, and for bilateral LHR 60 min. OHR patients were discharged aft er a median of 134.5 min, which was significantly shorter than LHR pat ients, whose median discharge was 225 min (P < 0.01). Pain scores, act ivity levels, analgesia requirements, and time taken to return to wlrk were not significantly differnt following surgery in either group (P < 0.05). There have been two recurrent hernias and one small bowel obs truction in the LHR group. We conclude that both repairs can be succes sfully performed as day surgical procedures. The added cost of LHR at this stage does not warrant its widespread use in unilateral hernia re pairs. Which procedure is adopted should be individualized; however, p atients with bilateral hernias on presentation can be successfully man aged as day cases, obviating the need for hospitalization or two opera tions.