Recurrences were more common in the group having laparoscopic surgery (87 of 862 patients (10.1%)) than in the group having open surgery (41/834 (4.9%) (odds ratio 2.2 95% confidence interval 1.5 to 3.2). A total of 1983 patients had an operation, and two year follow up was completed in 1696 of the patients (86%). The researchers randomly assigned 2164 patients aged 18 years or older to one of the two procedures. The primary outcome was recurrence of hernias at two years the secondary outcomes included complications and outcomes, such as reported pain and time off before returning to work. In the current study, researchers led by Dr Leigh Neumayer of the Department of Surgery at the University of Utah in Salt Lake City randomly assigned men with inguinal hernias at 14 Veterans Affairs medical centres to either open mesh or laparoscopic mesh repair. But the laparoscopic technique requires general anaesthesia (because the abdominal cavity has to be inflated with air) and it is more often associated with serious intraoperative complications than is open repair, although such complications are infrequent ( Lancetġ999 354: 185-90 ). Laparoscopic primary repair of hernias had been previously reported to result in low recurrence rates and to be associated with substantially less pain in the immediate postoperative period and earlier return to normal activities compared to open repair ( New England Journal of Medicineġ9-7 ). The open surgical repair of primary inguinal hernias is better than the laparoscopic technique for mesh repair, a new study has shown ( New England Journal of MedicineĢ004 350: 1819-27 ).
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