Open Mesh Repair for Inguinal Hernia is Safer than Laparoscopic Repair or Open Non-mesh Repair: A Nationwide Registry Study of Complications.

Abstract

Inguinal hernia repair is the most common elective procedure in general surgery. Therefore, the number of patients having complications related to inguinal hernia surgery is relatively large. The aim of this study was to compare complication profiles of inguinal open mesh (OM) hernioplasties with open non-mesh (OS) repairs and laparoscopic (LAP) repairs using retrospective nationwide registry data. The database of the Finnish Patient Insurance Centre (FPIC) was searched for complications of inguinal and femoral hernia repairs during 2002-2010. Complications of OM repairs were compared to complications of OS repairs and LAP repairs. Over 75 % of all inguinal hernia procedures during the study period in Finland were OM hernioplasties. FPIC received 245 complication reports after OM repairs, 40 after OS repairs, and 50 after LAP repairs. Reported complications were significantly more severe after LAP and OS repairs than OM surgery (p<0.001). Visceral complications (p<0.001), deep infections (p<0.001), and deep hemorrhagic complications (p<0.001) were overrepresented in the LAP group. In the OS group, visceral complications (p<0.001), recurrences (p<0.001), and severe neuropathic pain (p<0.001) predominated. LAP and OS repairs of inguinal hernia were associated with more severe complications than open surgery with mesh in this study.