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Things to consider
Technique Early complications Late complications Serious complications Economy What does NICE say
Added cost of laparoscopic does not warrant its use in unilateral hernias
Lawrence et al 1995: longer theatre time and greater complication rate Wellwood et al 1998: Laparoscopic costs greater Wright et al 2002: Similar outcome; no difference in chronic pain or recurrence Menon et al 2003: longer operating time and higher recurrence
Meta-analysis of laparoscopic inguinal hernia trials favors open hernia repair with preperitoneal mesh prosthesis C.Randle Voyles, M.D. Brian J Hamilton, B.S. William D Johnson, Ph.D. Nobuyasu Kano, M.D. 2002 Conclusions: Although LHR was associated with an earlier return to work compared with conventional sutured OHR, more recent mesh OHRs provide equivalent outcomes but at lower costs and potentially less severe complications, supporting an open technique using preperitoneal mesh prostheses as the optimal hernia repair.