Comparison between Traditional Surgery and Laparoscopic Surgery in the Treatment of Hernias in the Elderly

Abstract

Hernia repair in older patients typically involves a number of complexities related to the effects of aging on the body as well as underlying medical issues. This research has compared and contrasted open term with laparoscopically performed hernia repairs while evaluating operative outcomes, short-term recovery periods, complication rates, and long-term results. The terminal ambit of surgical evaluations showed that laparoscopy took about 10 minutes longer on average (95 ± 20 min) than open procedures (85 ± 15 min) during the course of surgery; however, the amount of blood lost during laparoscopic repair was much less (60 ± 20 ml versus 120 ± 30 ml). Regarding early recovery from surgery, patients undergoing a laparoscopic repair were able to ambulate sooner (1.5 ± 0.4 days post-op) when compared with patients undergoing an open repair (2.5 ± 0.5 days post-op), and exhibited fewer pain complaints (VAS 3 ± 1 versus VAS 6 ± 1), and stayed in the hospital for less time (3 ± 0.8 days versus 5 ± 1 days). The incidence of postoperative complications was higher in patients who had an open repair; for example, there were greater instances of wound-related morbidity due to wound infections (8% vs 3%) and seromas (10% vs 4%) in the open repair group when compared with the laparoscopic group. Incidence rates of cardiopulmonary events were somewhat higher during the immediate post-operative period in the laparoscopic group (6% vs 5%), however, all cardiopulmonary events were associated with an early post-operative period only. Recurrence rates of hernia at longterm follow-up were similar (4% laparoscopic vs 5% open), but laparoscopic repair patients exhibited more optimal functional status and greater patient satisfaction (90% vs 75%). Patients who had laparoscopic repairs also experienced significantly less chronic pain than patients who had open repairs (5% vs 12%). In conclusion, laparoscopic hernia repair provided numerous advantages to elderly patients over open procedure including shorter recovery time, lower complication rates and better long-term quality of life while presenting comparable rates of hernia recurrence.