Treating inguinal hernias: Editorial does not tell the whole story...

doi:10.1136/bmj.328.7436.403-b

BMJ 2004;328:403 (14 February), doi:10.1136/bmj.328.7436.403-b

Letter

Treating inguinal hernias

Editorial does not tell the whole story...

The first 150 words of the full text of this article appear below.

EDITOR—In his editorial Kingsnorth argues that open inguinalhernia repair with the Lichtenstein method is superior to thelaparoscopic approach.¹ We think that this is not the wholestory.

In a recent Cochrane review six visceral and seven vascularinjuries (in 2498 patients) were reported in the laparoscopicgroup compared with one and five (in 2758 patients) in the opengroup.² In the laparoscopic group the convalescence was significantlyshorter than after open surgery (7 days, P < 0.001). Furthermore,and probably most importantly, the review found a significantreduction in the rate of chronic groin pain (290/2101 v 459/2399,P < 0.001) after laparoscopic repair, with no differencein recurrence rates after the two procedures.

Although the direct cost of the laparoscopic technique is higher,this difference is eliminated by recommending a convalescenceof one week only.³

Kingsnorth's concern about the complex nature of the laparoscopicprocedure . . . [Full text of this article]

Emilie Øberg, research fellow

emilieberthelsen@hotmail.com

Jacob Rosenberg, professor

Department of Surgical Gastroenterology, Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark