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Advantages of open versus laparoscopic repair of inguinal hernia are debated frequently in the general surgery literature. In this meta-analysis of 27 randomized trials that involved 7200 patients, researchers compared open and laparoscopic approaches for treatment of unilateral inguinal hernia. Laparoscopic approaches were classified further as transabdominal preperitoneal (TAPP; the peritoneal cavity is entered) or totally extraperitoneal (TEP).
Findings were as follows:
Risk for hernia recurrence was significantly higher with laparoscopic than with open repair (relative risk, 2.06). The TEP procedure largely accounted for the excess recurrence with laparoscopy.
Perioperative morbidity also was significantly higher with laparoscopic than wit…