Is laparoscopic inguinal hernia repair an operation of the past?

s c C t t p p w p here is an ongoing debate about whether to repair priary, unilateral inguinal hernias by the laparoscopic or he open method. Many agree that laparoscopic repair is etter for bilateral or recurrent hernias, but its use for rimary, unilateral hernias is controversial. Sixteen ranomized, controlled trials and metaanalyses that compared hese two techniques demonstrated that laparoscopic repair as a definite role in modern surgery (Table 1). The VA ooperative Study is the most recently published large, rospective, randomized, controlled trial that compared aparascopic to open repair. The authors concluded that pen inguinal hernia repair is superior to laparoscopic nguinal hernia repair. They based their conclusion on a igher overall recurrence rate in the laparoscopic group 10% versus 4.9%) and a higher complication rate in the aparoscopic group (39% versus 33%). This article ight make one believe that laparoscopic inguinal heria repair is a procedure of the past. A thorough analysis f this admirable and ambitious project reveals many laws; it simply cannot be accepted as the definitive work n this field. In this article we will discuss the drawbacks f the VA Study, and we will also delineate the shortcomngs of some of the other published reviews in an atempt to illustrate why laparoscopic inguinal hernia reair is not a procedure of the past.