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Background <p>Laparoscopic inguinal hernia repair is increasingly used as an alternative to open repair. Our study investigates the 30-day outcomes of open vs. laparoscopic inguinal hernia repair in the population with obesity using the National Surgical Quality Improvement Program (ACS-NSQIP) database.</p> Methods <p>In this retrospective study, all patients with obesity who underwent inguinal hernia repair between the years 2015–2023 inclusive were selected from the ACS-NSQIP database. Patients who underwent open repair were matched with laparoscopic repair patients using propensity score. 30-day postoperative complication rates were compared between the open and laparoscopic groups including univariate and multivariate analysis. Subgroup analysis with emergency repair and recurrent hernia was conducted.</p> Results <p>There were 59,943 patients included including 30,289 patients undergoing open repair and 29,654 undergoing laparoscopic repair. The ratio of laparoscopic to open cases increased overall during the study period. The multivariate analysis showed a decreased rate of serious complication (OR 0.17, 95%CI 0.04–0.79). Furthermore, the multivariate analysis demonstrated odds ratio of serious complication of 0.63 (95%CI 0.34–1.17) in emergency repairs and 0.21 (95%CI 0.10–0.44) in recurrent cases when compared to open approach.</p> Conclusion <p>Laparoscopic inguinal hernia repair in patients with obesity demonstrated a lower rate of postoperative serious complications in the all-comers and recurrent repair subgroup and was comparable to open repair for the emergency surgery subgroup. This study further supports the safety of laparoscopic inguinal hernia repair as an alternative to open repair in patients with obesity.</p>

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Open versus laparoscopic inguinal hernia repair in patients with obesity: a NSQIP propensity-matched analysis of 59,943 elective, emergency, and recurrent cases

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Mary Hou,
  • Philip Mitchell,
  • Estifanos Debru,
  • Neal Church,
  • Daniel Meyer

摘要

Background

Laparoscopic inguinal hernia repair is increasingly used as an alternative to open repair. Our study investigates the 30-day outcomes of open vs. laparoscopic inguinal hernia repair in the population with obesity using the National Surgical Quality Improvement Program (ACS-NSQIP) database.

Methods

In this retrospective study, all patients with obesity who underwent inguinal hernia repair between the years 2015–2023 inclusive were selected from the ACS-NSQIP database. Patients who underwent open repair were matched with laparoscopic repair patients using propensity score. 30-day postoperative complication rates were compared between the open and laparoscopic groups including univariate and multivariate analysis. Subgroup analysis with emergency repair and recurrent hernia was conducted.

Results

There were 59,943 patients included including 30,289 patients undergoing open repair and 29,654 undergoing laparoscopic repair. The ratio of laparoscopic to open cases increased overall during the study period. The multivariate analysis showed a decreased rate of serious complication (OR 0.17, 95%CI 0.04–0.79). Furthermore, the multivariate analysis demonstrated odds ratio of serious complication of 0.63 (95%CI 0.34–1.17) in emergency repairs and 0.21 (95%CI 0.10–0.44) in recurrent cases when compared to open approach.

Conclusion

Laparoscopic inguinal hernia repair in patients with obesity demonstrated a lower rate of postoperative serious complications in the all-comers and recurrent repair subgroup and was comparable to open repair for the emergency surgery subgroup. This study further supports the safety of laparoscopic inguinal hernia repair as an alternative to open repair in patients with obesity.