MIS vs. Open Inguinal Hernia for Uncomplicated Unilateral Hernia

  • Fadi Balla
  • Ankit D. PatelEmail author


An inguinal hernia is one of the most commonly encountered general surgical pathologies in the world. Approximately 27% of males and 3% of females will develop one in their lifetime. The surgical treatment for inguinal hernias continues to evolve, with open herniorrhaphy with tension-free mesh repair (TFR) as the current gold standard across the world. With laparoscopy and now robotic surgery, minimally invasive methods have been accepted as suitable alternatives to the open repair. However, in the past, these minimally invasive methods were primarily reserved for recurrent hernias and bilateral hernias since they offered two unique benefits—working in previously unviolated anatomic planes and visualization of both inguinal areas in the same procedure. Unfortunately, more expensive equipment is needed for minimally invasive methods and may not be universally available. As a result, debate continues over the optimal repair method for uncomplicated unilateral inguinal hernias. In experienced hands, recurrence rates are similar in both open and laparoscopic repair (<2%) (McCormack et al., Cochrane Database Syst Rev (1):CD001785, 2003). Therefore, the decision-making process has shifted toward consideration of other post-procedural outcomes such as postoperative pain, time to return to daily activities, and early and late complications. Previous studies have shown that inexperience with laparoscopic inguinal hernia repair was associated with higher rates of postoperative complications. We aim to evaluate these factors and provide recommendations for the practicing general surgeon based on current and practical data.


MIS Open inguinal hernia Uncomplicated unilateral hernia Open repair Open herniorrhaphy Tension-free mesh repair Laparoscopic inguinal hernia repair 


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Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2019

Authors and Affiliations

  1. 1.Department of SurgeryEmory School of MedicineAtlantaUSA
  2. 2.Division of General and GI SurgeryEmory University School of Medicine, Emory Bariatric Center, Emory Saint Joseph HospitalAtlantaUSA

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