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Volume 351:1463-1465 September 30, 2004 Number 14
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Open Mesh versus Laparoscopic Mesh Hernia Repair

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by Neumayer, L.
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To the Editor: Life-threatening complications and a high rate of recurrence of hernias (10.1 percent) cast doubt on the safety and clinical effectiveness of laparoscopic hernia repairs in the trial reported by Neumayer et al. (April 29 issue).1 Laparoscopic total extraperitoneal repair is generally considered superior to transabdominal preperitoneal repair. Transabdominal preperitoneal repair is associated with serious, though uncommon, complications such as visceral injury. In a Medical Research Council trial, all serious complications and port-site hernias developed in the 94 patients who had undergone transabdominal preperitoneal repair.2 The National Institute for Clinical Excellence, in the United Kingdom, favors total extraperitoneal . . . [Full Text of this Article]



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