Incisional and ventral hernia repair

Laparoscopic versus open repair

Meta-analyses show similar recurrence but fewer SSIs and a shorter stay with laparoscopic repair. Put as one statement: laparoscopic repair reduces wound infection and length of stay, and the lap or robotic approach gives a lower SSI with similar recurrence.

Four statements are set beside that one and each is wrong. Laparoscopic repair does not carry a higher recurrence. Open repair does not have fewer wound infections. Open repair is not mandatory for defects greater than 5 cm. And mesh is not contraindicated laparoscopically.

What decides the approach

The choice depends on defect size, location and expertise. That is why no size on its own makes open repair mandatory: a defect greater than 5 cm does not by itself decide the route.