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Recently in the Indian Journal of Surgery [1], an interesting article on the various techniques used for the inguinal hernia repair was published. Data reported from Western countries revealed some differences. In particular, a study conducted in Boston, USA, reported that laparoscopic approach could be a cost-effective treatment option for inguinal hernia repair [2]. In order to compare these differences, further considerations are necessary. In fact, laparoscopic hernia repair has been widely recommended in the past 20 years, but this procedure, in Europe, is nearly €400 more expensive than ambulatory (or 1-day) anterior mesh (Lichtenstein) herniorrhaphy [3]. Every year in the USA, the UK, and Italy nearly 8 [4], 80000, and 150000 inguinal herniorrhaphies, respectively, are performed.  If all of these operations are done laparoscopically, the annual hospital costs of each state would be €320 million (USA), €32 million (UK), or €60 million (Italy) higher, respectively.  In conclusion, if all these techniques, in the hands of expert surgeons, have the same rates of recurrence and complications, in order to reduce and contain the hospitalization costs for hernia surgery, laparoscopic herniorrhaphy should be used only in very selected cases as plurirecurrent inguinal hernias. Actually, the preferred operation for inguinal hernia should be ambulatory (or 1-day) anterior mesh (Lichtenstein) herniorrhaphy.

Cutting Costs in Inguinal Hernia Surgery: Laparoscopic or Ambulatory (or 1-day) Open Hernia (Lichtenstein) Repair?