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Dr. Towfigh, the paper does not say that lap is better than open. It actually ends suggesting that open is the best. But, it’s about economics.
I was actually thinking of this recently. Where are the lawsuits for Lichtenstein repairs? There don’t seem to be any.
One person who might have an objective opinion about open mesh versus laparoscopic mesh would be David Chen of the UCLA Lichtenstein Amid Hernia Clinic.
Here is a recent presentation of his that is very educational in many different ways. He sounds very confident, as we were all taught to be when giving presentations. But if you look at the numbers there is still much work to do. And he does not offer a path to reach the goals he describes. He does offer things to avoid though, like plugs. You can also derive from his presentation that if you decide to get an open repair with mesh you should probably find a well-trained Lichtenstein method surgeon. Not a 10 minutes and done plug surgeon.
Overall, he is suggesting that open mesh, lap, and robotic are all about the same. He does not promote that lap mesh as better than open. The presentation is worth watching, just for general knowledge.
It is from 2017 but not much has changed, except for more robotics.