Current practices and outcomes in inguinal hernia management: A multi-centric prospective analysis of 2679 cases comparing open and laparoscopic repair in the Indian patients.

Abstract

Introduction: Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide, yet limited large-scale data exist comparing open and laparoscopic approaches in the Indian population. This study aimed to compare outcomes between these surgical techniques across multiple centres in India.

Patients and methods: This multi-centric prospective observational study was conducted by Sir Ganga Ram Hospital in collaboration with the Indian Association of Gastrointestinal Endo Surgeons. Data on all groin hernia surgeries performed over 3 months were collected, with patient outcomes assessed at 30 and 90 days postoperatively using the Clavien-Dindo classification system.

Results: A total of 2679 patients underwent inguinal hernia repair: 1592 underwent open surgery and 1087 underwent laparoscopic surgery. The laparoscopic group was significantly older with higher body mass index, and bilateral hernias were more common. Laparoscopic repair demonstrated significantly lower post-operative day-one pain scores, reduced major medical complications and lower surgical site infection rates at 30 days. Chronic groin pain at 90 days was significantly less common in the laparoscopic group. No significant differences in recurrence rates were observed at 90 days.

Conclusion: This large-scale Indian study demonstrates that laparoscopic inguinal hernia repair offers significant advantages, including reduced post-operative pain, lower complication rates and decreased chronic groin pain compared to open repair. The findings support selective laparoscopic application for bilateral hernias, obese patients and those with metabolic comorbidities while highlighting the need for standardised protocols in Indian healthcare settings.