Open Surgery Versus Laparoscopy

Each surgery option has advantages. In this regard the advantages of one approach are the disadvantages of the other.  To a large extent, which option a patient chooses should be based upon what aspects are most important to him or her.

Open surgery:

• Can be performed under local anesthesia (with the patient awake)
• Often has a better cosmetic result because the surgeon is able to remove excess tissue and tighten the skin where the hernia was
• May have less of chance of hernia recurrence than the laparoscopic approach. (To date, there are no scientifically valid studies documenting the recurrence rate for open repair compared to the laparoscopic approach.)
• Is less costly to your insurance provider

Laparoscopy:

• Has been available since the early 1990s, and its development was based on the success observed with laparoscopic gallbladder removal
• Can result in less recovery pain
• Can result in an earlier return to normal activities
• Requires general anesthesia (the patient must go completely to sleep)
• Costs your insurance company more than the open approach

Which is the better approach?

This situation is not like that for a groin or inguinal hernia where equal or superior results have been documented for the laparoscopic approach. In most cases, the open approach is the best and safest way to repair an incisional hernia.  However, there are situations in which patients may benefit from the laparoscopic approach.  Thus, incisional hernias are not like inguinal hernias where advantages are present for most patients with the laparoscopic approach.

Do all surgeons perform both the laparoscopic and open approaches?

No.  All surgeons perform the open approach but only some surgeons perform the laparoscopic approach.  It is important in getting an opinion regarding your surgery to determine if the surgeon performs one or both approaches and how many of each he or she has performed.