To fix or not to fix – that is the question!
Certainly patients who present with a symptomatic inguinal hernia prefer to have that repaired. But what about the patient who has an asymptomatic or minimally symptomatic inguinal hernia, should those be repaired as well? A recent systematic literature review demonstrated that patients will have “less pain overall with surgery compared to a watchful waiting approach” since many of those patients who are not asymptomatic will become symptomatic in the future. In fact, in 2010 a watchful waiting approach was adopted in several areas of Great Britain and found after the policy change a 59% higher odds of emergency repair with a 3 times increased risk for adverse events as well as a mortality of 5.4%!
How to fix?
Studies have shown that when comparing laparoscopic to an “open” approach to repairing these hernias that there is a 60% reduction in risk for chronic pain as well as a significantly reduced risk of acute pain. There is a significantly increased risk for infection, readmission, and opioid use with open repair. As a result, patient satisfaction rates are significantly higher with the laparoscopic approach.
We are specialists in laparoscopic and robotic approaches in general and gastrointestinal surgery.