Open or Closed? Which Method Should I Prefer?

The contemporary discussion is about if the mesh should be placed as applied since years, with the open method, or the newer closed (laparoscopic) method. My personal opinion is that the more the cost of the closed method decreases, the laparoscopic experience of the general surgeon increases and the worth paid to human increases, the closed method will be wide-spread in short-term.


Advantages of the Closed Method

The operation can be performed by very small openings. That the cuts are shorter, reduce also the risks of wound complications. Early or late pains, simple wound infections are seen less. That the cuts are short provide also an advantage in cosmetic aspects. After a short time, it gets impossible to find the locations of the cuts.

During the Closed Operation both right and left inguinal channels can be seen. E.g. if there should be a suspect regarding the second side, it is possible to examine this side also during the surgery. In addition, it is possible to repair both sides with the same holes. At dual side inguinal hernias, the laparoscopic method is very advantageous. When the dual side repair is performed by the Open Method, there is more tissue damage and wound complication risk.

The return to work, social life and sport after the Closed Method is much faster. The Closed Method offers, including such working in offices, in relation to the difficulty of the profession a serious advantage; it is an ideal method especially for sportsmen and those working with their bodies.

It is possible to repair re-incurred hernia, without entering the surgery location from the backside. If the firs surgery was with the Open Method, as the anatomy of the region will be damaged, at such cases the Open Method will contain technical difficulties and has a potential for complications. Therefore, the Closed Method is also successful at re-incurred hernia.

The long-term results for the Closed Method are also gathered. At backward studies, both at the initial application and at application regarding re-incurred hernia, it is determined that the Closed Method is as successful as the Open Method. The re-incur ratio are both the same and low. Also regarding other complications, the Closed Method shows more successful results.

The closed method is the ideal solution at those with dual-side hernia or with suspect of hernia on the other side too, professional sportsmen, continuously sportive persons, those who want to turn back to work soon or those, whose profession needs physical strength or re-incurred old hernias.


Disadvantages of the Closed Method

Cost: There are devices to be used in order to apply the closed method, and beside this, there are consumables, which are for unique use and are disposed after the surgery. The cost of the closed operation is 1.000 TL more expensive than the open surgery.

General Anaesthesia: The closed operation is only made under general anaesthesia. Therefore, the must be no hinder for a general anaesthesia at the person to be operated.

Need of Experience: The physicians, who will perform the closed operation, must me surgeons, who have experience in laparoscopic operations. Whilst all surgeons are furnished with the education to perform open hernia operations, the number of the physicians, who are able to perform closed operations are comparatively low both in the world and in our country.

Not Applicable to Some Patients. In which cases to whom can the closed operation not be applied: The closed method should not be used at strangulated hernias, at over weighted persons at obesity level, at some huge hernias, at pregnant, those with blood diseases or those, who continuously use blood diluting medications.

The closed operation is the ideal solution if you should have hernia on both sides, if you should have had an operation by the open method before cause of inguinal hernia and if this should have re-incurred, if you are sportsmen, have your own business or want to turn back to work as soon as possible. Except this, anyone, who means that the cost is no matter, can have a closed operation.

You may chose the open operation if you are retired, have a single side hernia, if there should be a problem regarding being under general anaesthesia or if the cost of the operation should be important for you.


THE HERNIA CENTRE
We know that our work is human focussed. We believe that the human is in the centre of all our professional activities and that our target is somehow preventive medicine.
THE HERNIA CENTRE
We know that our work is human focussed. We believe that the human is in the centre of all our professional activities and that our target is somehow preventive medicine.
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Teşvikiye Mah. Hakkı Yeten Cad. No:23 Kat:8 Med-Ofis Fulya / Şişli / İSTANBUL
Vital Fulya Plaza
Teşvikiye Mah. Hakkı Yeten Cad.
No:23 Kat:8 Med-Ofis
Fulya / Şişli / İSTANBUL