Costs and quality of life after endoscopic repair of inguinal hernia vs open tension-free repair - A review

Background: The ongoing debate about the relative merits of endoscopic (EH) vs open mesh herniorrhaphy (OH) prompts the need for comparisons of outcome measures other than recurrence. Therefore, we reviewed data on the costs, time to return to work, quality of life (QoL), and pain associated with EH and OH. Methods: Studies comparing EH to OH and explicitly involving costs or QoL were identified and reviewed. Results: Eighteen studies were included. Direct in-hospital costs were higher for unilateral EH. Direct out-of-hospital costs were lower after EH in some studies. Indirect costs were lower for EH. Total costs were higher for EH in three studies and lower in one study. With EH, QoL was better, pain was less, operating time was longer, and time return to work and other activities was shorter. Conclusion: From a societal perspective, EH entails costs similar to OH but offers extra benefits to the patient in terms of QoL and pain.