Virgin and Recurrent Groin Hernia: A Comparison of Patient Recovery Following Endoscopic Preperitoneal Herniorrhaphy

INTRODUCTION: The advantage of minimally invasive hernia repair techniques remains controversial. One of the more established indications for this technique's use is the presence of a recurrent hernia. No prior study has compared the recovery following endoscopic repair of virgin and recurrent hernias. PATIENTS AND METHODS: Between July 15, 1994 through August 16, 1996, one primary surgeon supervised the performance of 373 hernia repairs on 250 patients. Twenty-two patients underwent endoscopic preperitoneal herniorrhaphy for unilateral recurrent groin hernia (RH), while 105 patients underwent repair of a virgin unilateral hernia (VH) in the absence of prior contralateral open hernia repair. No significant differences were seen for age (VH: 54, RH: 64), male:female ratio (VH: 92:13, RH: 22:0), operative time (VH: 58 min, RH: 59 min), anesthetic used, IV fluid requirements or blood loss (p > 0.05 for all comparisons). At the time of discharge, all patients were given a postoperative survey and asked to record their level of pain, narcotic use, and level of activity on the day of surgery and postoperative days 1, 2, 3, 7, 14, and 28. RESULTS: Patients undergoing repair of virgin hernias had statistically significant increased levels of pain and/or narcotic use on the day of surgery and postoperative days 1, 2 and 3. Despite these differences, level of activity and return to work/normal activity (VH: 6.35+/- 3.44 days, RH: 6.40 +/- 2.67 days) were the same for the two groups. CONCLUSION: Despite the differences in pain perception and narcotic use in the early postoperative period, overall patient recovery appears similar for the two groups. Differences seen are likely due to a lack of any prior surgical pain to serve as a benchmark for comparison.