Not least due to the results of Open Tension-Free Repairs performed and published internationally by The British Hernia Centre, the stitching of hernias is now hardly used in the developed world.
It remains the view of The British Hernia Centre that laparoscopy is not the method of choice in the majority of cases of hernia repair.
The other and extremely common method employed these days is a technique of mesh repair that is normally performed under general anaesthesia. The table gives a comparison of the benefits, suitability and risks of the three main approaches.
| Tension-Free Mesh under Local Anaesthesia * | Laparoscopic ** (‘Keyhole’) repair | General Anaesthesia Mesh Repair | |
| Return to Normal Routine | Rapid | Rapid/Variable | Variable |
| Post-Operative Discomfort | Moderate/Low | Moderate/Low | Variable |
| Technical Difficulty (For the surgeon) | Routine (by BHC-specialists) | High | Average |
| Risk of Major Organ or Blood Vessel Damage | Negligible | High | Negligible |
| Complication Risk From General Anaesthetic | NONE | Present | Present |
| Suitable for Elderly etc | Yes | Not Really | Often Not |
| Suitable for Patients with Other Medical Conditions | Yes | Often Not | Often Not |
| Overall | Method of Choice in most cases | An Option in Some Cases | Only in more complex cases |
* This column relates specifically to operations performed by the specialist surgeons at The British Hernia Centre. Similar results cannot be guaranteed elsewhere or by non-hernia specialists.
** Keyhole surgery plays a very effective role in many types of surgery. We only speak here of its use in hernia repair.
After keyhole repairs, although the post-operative recovery time is noticeably better than with the old ‘tension-stitching‘ methods, even these results do not exceed the overall speed of recovery achieved at The British Hernia Centre with tension-free repairs.
The results for keyhole surgery patients are comparable with the results achieved at The British Hernia Centre, yet our preferred approach is without the risks attached to keyhole surgery.
The keyhole repair requires general / spinal anaesthesia, our technique requires only local anaesthesia. Also, the risks associated with operating whilst watching a 2 dimensional TV screen do not compare with the ‘fingertip’ control of the British Hernia Centre’s technique.
The view favouring the described technique over keyhole surgery is supported in reports published by the Royal College of Surgeons and elsewhere as well as The British Hernia Centre.
We are often asked if the operation being offered at any given local hospital is as described here. For an easy way to find out, see the
FAQ (Frequently Asked Questions) section specifically on this.
See also Academic Publications referring to the unsuitability of certain cases to either laparoscopic or anterior repair.
Surgeons of The British Hernia Centre:
The World Journal of Hernia and Abdominal Wall Surgery 9: 105 (2005)