A SURVEY OF PREFERRED APPROACH TO INGUINAL-HERNIA REPAIR - LAPAROSCOPIC OR INGUINAL INCISION

The recent interest in laparoscopic surgery has raised some concerns t hat large numbers of surgeons were recommending this ''minimally invas ive'' approach in procedures such as inguinal herniorrhaphy before the availability of adequate data regarding safety and benefits. To deter mine current experience and preference levels for laparoscopic inguina l herniorrhaphy (LH), we conducted a mail survey of New Jersey surgeon s. Of 531 respondents, 430 (81%) preferred a traditional inguinal inci sion approach over a laparoscopic approach (8%). Of 344 general surgeo n respondents, 227 (66%) had experience with laparoscopic cholecystect omy, but only 56 (16%) had experience with LH. This latter group had p erformed only an average of 9.2 laparoscopic herniorrhaphies, with a m edian of five cases. Most of these 56 surgeons with LH experience indi cated a preference for inguinal incision herniorrhaphy although 19 sur geons who had performed 10 or more LH cases showed a slight preferranc e for LH (11 to 8). The primary reasons for choosing LH included ''les s pain'' and ''quicker recovery.'' The primary reasons for choosing in guinal incision herniorrhaphy included having a ''better known procedu re'' and avoiding general anesthesia. Our survey indicates that the la paroscopic approach to inguinal hernia repair has currently accumulate d few proponents in the surgical community since many surgeons are wai ting for more data on the procedure.