DOCTOR'S VIEW ARCHIVE

Hernia Repair…Laparoscopy Success

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UTRECHT, NETHERLANDS 1997 - As medical technology progresses, changes in the techniques used to perform medical procedures are inevitable.

The laparoscope is a tube-like viewing instrument used to inspect, biopsy, and repair tissues inside of the abdomen. Procedures utilizing a laparoscope require only small incisions (less than an inch) for the instrument to be inserted into the cavity of the abdomen. This technique reduces healing and recovery time while minimizing scars on the skin.

Dr. Mike S. L. Liem and others at the University Hospital Utrecht in the Netherlands reported their treatment of 487 patients for hernia of the groin using the laparoscope and compared results with 507 patients using traditional open surgical repair. (New England Journal of Medicine 1997;336:1541- 7)

Dr. Liem's study found that the patients who had undergone repair with the laparoscope recovered more rapidly than those who had open surgical repair. The average time to resume normal daily activity was 6 days using the scope versus10 days with open surgery. The average time to return to work was 14 days compared to 21 days. The average time to resume athletic activity was 24 days versus 36 days.

Dr. Liem's study also found that the patients who had undergone repair with the laparoscope had fewer recurrences (3 percent) than those who had open surgical repair (6 percent).

Whether laparoscopic groin hernia repair by the laparoscope method will now become accepted as both effective and safe long-term awaits further study.

"Scope" procedures for removal of the gallbladder, evaluation and repair of the ovaries, lungs, stomach, colon, and joints are now commonplace in community hospitals. As modern surgical methods and technology evolve, various traditional surgical procedures may become more amenable to scope methods. There are already reports of successful heart operations using scope techniques!