Open vs laparoscopic repair of secondary lumbar hernias: a prospective nonrandomized study
Lumbar hernias are uncommon defects of the posterior abdominal wall. Surgical treatment is still controversial in these cases. The aim of this study was to compare outcome and costs of the laparoscopic approach vs the open method.
We conducted a prospective nonrandomized study of 16 patients who underwent operation for secondary lumbar hernia between January 1997 and January 2003. Hine were treated via the laparoscopic approach and seven with an open technique. The following variables were analyzed: clinical data, hospital data (operating time and length of stay), patient comfort (consumption of analgesics and time to return to normal activities), and recurrences. Hospital costs were also analyzed.
There were no differences between the two groups in terms of age and history, although the defects of the patients in the laparoscopic group were smaller. Mean operating time, postoperative morbidity, mean hospital stay, consumption of analgesics, and time to return to normal activities were significantly lower in the laparoscopic group (p < 0. 01). No were there any statistical differences between the two types of surgical procedure in terms of hospital costs. However, the final cost did show differences when expenses for readmissions and recurrences were taken into account (p < 0.01).
The laparoscopic approach to secondary lumbar hernia repair is more efficient and more profitable than the traditional open technique.
KeywordsLumbar hernia Laparoscopy Major ambulatory surgery Costs
- 1.Alexandre, JH, Bouillot, Jl (1994) “Traiteiment chirurgical des hernies lombaires” In: Horay, P. Encycl. Med. Chir. Techniques chirurgicales—Appareil digestif, Elsevier, paris, pp 40–152Google Scholar
- 4.Carbajo, MA, Martín Olmo, JC, Blanco, JI, et al. 1999Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with meshSurg Endosc113235Google Scholar
- 5.Devlin, HB, Kingsnorth, A. 1998Lumbar herniaDevlin, HBKingsnorth, A eds. Management of abdominal hernias2Chapman & Hall MedicalLondon223224Google Scholar
- 6.Geis, WP, Hodakowski, GT 1995Lumbar herniaNyhus, LMCondon, RE eds. Hernia14JB LippincottPhiladelphia412423Google Scholar
- 9.Moreno-Egea, A, Aguayo, JL 2002Ambulatory laparoscopic repair of inferior lumbar or petit hernia: a case reportSurg Endos161107Google Scholar
- 10.Moreno-Egea, A, Carrasco, L, Girela, E, Martín, JG, Aguayo, JL, Canteras, M 2002Open vs laparoscopic repair of spigelian hernia: a prospective randomized trialArchi Surg13712661268Google Scholar