Laparoscopic Versus Open Inguinal Hernia Repair: A Retrospective Cohort Study on Surgical Approach Preference and Perioperative Outcomes

Abstract

Objectives: This study investigates preferences for these methods and assesses perioperative outcomes at a tertiary center. Methods: A retrospective cohort study analyzed electronic health records of 244 patients undergoing inguinal or femoral hernia repair from January 2022 to April 2025. The primary outcome was the proportion of laparoscopic versus open procedures. Secondary outcomes included operative duration (minutes), hospital stay (days), and postoperative recurrence. Data encompassed patient demographics, hernia characteristics, and surgical details. Statistical analyses used chi-square tests for proportions, Mann-Whitney U tests for non-normal data, Fisher’s exact test for recurrence, and multivariable regression adjusting for confounders like age, BMI, and additional surgeries.
Results: Of 244 procedures, 29.1% (n=71) were laparoscopic, and 70.9% (n=173) were open (p<0.001). Laparoscopic use showed no significant rise over time (p=0.811). Median operative times were comparable (laparoscopic: 130.0 min, IQR 105.0–182.0; open: 120.0 min, IQR 94.5–165.0; p=0.372), as were hospital stays (1.0 day, IQR 1.0–2.0; p=0.920). One recurrence (0.4%) occurred in the open group (p=0.999).
Conclusion: Open repair is predominant, likely due to institutional factors. Similar outcomes indicate both methods are effective, with laparoscopic preferred for bilateral hernias²⁰. Multicenter studies with longer follow-up are needed to improve surgical decisions²¹.