- Design
- Nationwide register- and survey-based cohort
- Population
- 9,552 adults after elective mesh repair of primary ventral hernia <10 cm
- Primary outcome
- Patient-reported pain, scar dissatisfaction and recurrence
- Effect
- Scar dissatisfaction 4.2% robotic, 5.7% laparoscopic vs 10.2% open
A Danish nationwide register and survey study assessed 9,552 of 12,040 eligible adults (79%) after elective mesh repair of umbilical or epigastric hernias under 10 cm, using the Abdominal Hernia-Q.
Severe chronic pain, foreign body sensation and physical impact did not differ by approach. Scar dissatisfaction was lower after laparoscopic (5.7%) and robotic (4.2%) repair than open (10.2%). Self-reported recurrence was slightly higher after laparoscopic than open repair (11.4% vs 9.2%, difference 2.2%, 0.6 to 3.7).
For small primary hernias, approach does not change long-term pain. Where appearance matters to the patient, a minimally invasive repair has an advantage; otherwise open repair remains a reasonable, cheaper choice.
- Ask patients whether scar appearance matters to them before choosing an approach.
- Counsel that chronic pain risk is similar across approaches.
- Weigh the small recurrence difference with laparoscopic repair against cosmetic benefit.
- Open mesh repair remains appropriate where laparoscopic or robotic access is limited.
Why it matters
It removes chronic pain as a reason to prefer one approach over another for small primary hernias.
Don't overread it
Recurrence was patient-reported, not examined, and the approaches were not randomised.
The statistics, in plain English
The scar difference of about 5 to 6 percentage points is precise and meaningful to patients who care about appearance. The recurrence difference of 2.2 points is statistically significant but small, and self-report may over- or under-count true recurrence.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for general surgery, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free