# The Pros and Cons of Minimally Invasive Surgery Versus Open Surgery for Inguinal Hernia Repair: A Narrative Literature Review

## TL;DR

This review compares laparoscopic and open surgery for inguinal hernia repair, showing laparoscopic methods offer faster recovery and fewer complications, though they are more expensive and technically demanding.

## Contribution

A comprehensive narrative review comparing postoperative outcomes and cost implications of laparoscopic versus open inguinal hernia repair.

## Key findings

- Laparoscopic repair reduces analgesic use by 42% and shortens recovery time to light activity by 6 days.
- Patients report higher satisfaction with laparoscopic repair (88.7%) compared to open repair (79.3%).
- Laparoscopic techniques have lower wound infection and chronic pain rates but higher seroma formation (15.8-22%).

## Abstract

The choice between minimally invasive laparoscopic and open surgical approaches for inguinal hernia repair significantly impacts postoperative outcomes, particularly in terms of pain management, recovery time, and patient satisfaction. This literature review synthesizes findings from multiple studies to provide a comparative analysis of these two techniques. Evidence consistently demonstrates that laparoscopic repair demonstrates clear advantages, with patients using 42% fewer analgesics in the first 48 hours, returning to light activity in 8 days compared to 14 days for open repair, and to full activity in 13.6 versus 19.8 days. Furthermore, hospital stays are shorter (1-2 days vs. 2-4 days), and overall satisfaction is higher (88.7% vs. 79.3%). Additionally, complication profiles also differ; laparoscopic repair is linked to lower rates of wound infection, hematoma, and chronic pain, though seroma formation is somewhat higher (15.8-22%). However, laparoscopic techniques are associated with higher upfront costs and require greater surgical expertise, leading to longer operative times, particularly for novice surgeons. While open surgery remains a viable option for certain patient populations, such as those unable to undergo general anesthesia or with complex hernias, laparoscopic repair is increasingly regarded as the superior approach for most cases. This review highlights the clinical and economic implications of these techniques, advocating for patient-centered decision-making to optimize outcomes. With advancements in surgical training and cost management, the benefits of laparoscopic repair can be extended to a broader patient population.