BMJ 1996;312:309-310 (3 February)

Letters

Surgeons in study were inexperienced at laparoscopic repair

EDITOR,--Kate Lawrence and colleagues conclude that more complications occur after laparoscopic than after open repair of inguinal hernias and that costs are higher.1 There are, however, several flaws in their study.

At the start of the study the most experienced laparoscopic surgeon had performed only 20 repairs and the others had performed fewer, though the number is not stated. It is questionable whether comparing the laparoscopic repairs of surgeons on the steep part of the learning curve (which would include the surgeon who had done 20 repairs) with their experience of open hernia repair, which no doubt amounted to many hundreds of cases, is a fair evaluation of the technique.

The authors' theatre staffing perhaps reflects the approach of affluent teaching hospitals to both medical and nursing staff, with both a senior theatre nurse and a surgical registrar being present in addition to the operating surgeon. In Colchester, and no . . . [Full text of this article]


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Relevant Article

Randomised controlled trial of laparoscopic versus open repair of inguinal hernia: early results
Kate Lawrence, Douglas McWhinnie, Alex Goodwin, Helen Doll, Andrew Gordon, Alistair Gray, Julian Britton, and Jack Collin
BMJ 1995 311: 981-985. [Abstract] [Full Text]

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