Endo-laparoscopic inguinal hernia repair: What is its role?

Hernia repair techniques vary greatly depending upon the setting, surgeons, insurance reimbursement systems, resources, and logistical capabilities. Open mesh repair is the most frequently used technique. Choosing the best technique for inguinal hernia repair is a challenge. There is no single technique to manage every type of hernia. Today, laparoscopy and robotics are at the forefront of advanced surgical tools and offer a range of options for general surgeons who are critically evaluating new procedures. However, before using a new procedure, such as endo-laparoscopic hernia repair, surgeons often ask the rhetorical question, "Why change?" The common considerations are the availability of equipment, familiarity with the anatomy when using these techniques, operative time, cost to the patient, and the potential need to convert to an open procedure. Additionally, we are now seeing a significant shift away from surgeon-defined benefits to patient-defined benefits. As patients become more aware of their options for hernia procedures and share their experiences, more and more patients are likely to demand a particular technique. Hence, hernia surgeons should be educated on the different techniques available for inguinal hernia repair, including endo-laparoscopic procedures. In this article, we review the existing literature on the current role of endo-laparoscopic inguinal hernia repair.