NICE has made the following recommendations about the use of laparoscopic surgery to treat inguinal hernia.
Laparoscopic surgery can be used as an option for repairing inguinal hernia. As with all surgery, there are some risks involved, which may include serious problems just after the operation, pain or numbness in the area of the operation, and the hernia coming back. Your doctor should tell you about the risks and benefits of each of the types of surgery (open surgery, or laparoscopic surgery using either the TAPP or TEP methods) before you make a decision on which method to have. In helping you make this decision you and your doctor should particularly consider:
- how well you are likely to cope with a general anaesthetic
- whether this is your first hernia, or whether it has come back or affects both sides of the groin
- whether an open or keyhole operation would work best for your particular hernia
- how much experience the surgeon has in the three techniques.
NICE has also said that laparoscopic surgery for inguinal hernia repair by TAPP or TEP should only be performed by specially trained surgeons who regularly carry out the procedure.
This guidance updates and replaces NICE technology appraisal 18 (published in January 2001).
Additional funding information for this guidance can be found on the Department of Health website.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.