1 Guidance

1 Guidance

This guidance replaces 'Laparoscopic surgery for hernia' (NICE Technology Appraisal Guidance 18) issued in January 2001.

For details, see 'About this guidance'.

1.1 Laparoscopic surgery is recommended as one of the treatment options for the repair of inguinal hernia.

1.2 To enable patients to choose between open and laparoscopic surgery (either by the transabdominal preperitoneal [TAPP] or by the totally extraperitoneal [TEP] procedure), they should be fully informed of all of the risks (for example, immediate serious complications, postoperative pain/numbness and long-term recurrence rates) and benefits associated with each of the three procedures. In particular, the following points should be considered in discussions between the patient and the surgeon:

  • the individual's suitability for general anaesthesia

  • the nature of the presenting hernia (that is, primary repair, recurrent hernia or bilateral hernia)

  • the suitability of the particular hernia for a laparoscopic or an open approach

  • the experience of the surgeon in the three techniques.

1.3 Laparoscopic surgery for inguinal hernia repair by TAPP or TEP should only be performed by appropriately trained surgeons who regularly carry out the procedure.