[Endoscopic repair of groin hernia--what ist evidence-based].
The endoscopic techniques of groin hernia repair have developed tremendously over the past 10 years. There are numerous prospective randomized clinical trials comparing conventional techniques of groin hernia repair with endoscopic methods. However, it is difficult to establish a proper meta-analysis of the currently available data due to widely differing study designs. We assessed the currently available prospective randomized clinical trials comparing conventional versus laparoscopic hernia repair. We conclude that based on present data there is a clear advantage for the endoscopic techniques regarding length of hospital stay, postoperative recovery and return to normal activity. The conventional techniques are superior regarding duration of operation and direct cost. Rate of recurrence are comparable in both, endoscopic and conventional approach using mesh prosthesis. Endoscopic techniques are far superior to conventional operation without the use of mesh prosthesis. In patients with recurrent hernia endoscopy offers a major advantage regarding postoperative pain, lenght of hospital stay, return to normal activity and rate of recurrence. We demonstrate these suggestions discussing our own results. Therefore we recomend endoscopic hernia repair in patients with bilateral or recurrent hernia.
Schmid
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A
Klinik für Chirurgie Kantonsspital Aarau, Aarau.
Schlumpf
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R
D004724:Endoscopy / Q000191:economics; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D015201:Meta-Analysis as Topic; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013526:Surgical Mesh; D013997:Time Factors