Letters

Why does NICE not recommend laparoscopic herniorraphy?

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7359.339 (Published 10 August 2002) Cite this as: BMJ 2002;325:339

Patients must consider potential serious complications

  1. David Watkin, consultant surgeon (retired) (davidwatkin@btinternet.com)
  1. Leicester Royal Infirmary, Leicester LE1 5WW
  2. Ipswich Hospital, Ipswich IP4 5PD
  3. Department of Digestive Surgery, Hotel-Dieu, Boulevard Leon Malfreyt, F-63058, Clermont-Ferrand, France

    EDITOR—The juxtaposition of Motson's article and the review of marrow transplantation for breast cancer is intriguing. 1 2 Both articles refer to new technologies, strongly supported by interest groups. In thecase of supra-lethal chemotherapy with marrow transplant rescue the evidence has now been discredited. For the repair of groin hernias the case is not clear cut. Certainly, patients should be informed of the laparoscopic option, with its short term advantages of reduced postoperative pain andtime off work.


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    Credit: SIU/SPL

    There is a downside, however. The review article that Motson quotes includes data on the small risk of potentially serious complications, which were more frequent with the laparoscopic operations in a ratio of 15:4.3 Informed consent must surely includemention of the possibly devastating intra-abdominal injuries, even though the incidence is only ofthe order of 2.5 per 1000 …

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