Laparoscopic hernia repair enhances early return of physical work capacity

Several researchers have documented less postoperative pain and a quicker r eturn to daily activities after laparoscopic herniorrhaphy, However, little objective data that validates this hypothesis exists. This study compares the rate of postoperative physical work capacity with return to preoperativ e levels, which is measured by a standard treadmill test in patients who un derwent laparoscopic and conventional open hernia repair. Patients complete d a 6-minute walking test preoperatively and 1 week postoperatively using a nonmotorized treadmill. The distance walked was recorded. If the distance that a patient achieved at 1 week was not within 0.02 miles of the preopera tive values of the patient, the patient was asked to return at 1 month for repeat testing. Patients were enrolled prospectively in this study from Oct ober 1997 to February 1999. Sixty-six patients participated in the study (2 7 laparoscopic herniorrhaphies and 39 open herniorrhaphies were performed). There was no significant difference in age body mass index, or preoperativ e distance achieved among the two groups. At 1 week, patients who underwent laparoscopic repair demonstrated a mean increase of 18 meters from preoper ative distance (P = 0.07), In the open group, patients demonstrated a mean decrease of 90 meters at week (P = 0.001), The change in distance at 1 week between the laparoscopic and the open groups was statistically significant (P = 0.001). However, at 1 month, there was no significant difference amon g the two groups. Measured using treadmill walking, laparoscopic hernia rep air seems to offer an early advantage to open repair in return-to-physical- work capacity.