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April 1995

Laparoscopic or Open Inguinal Herniorrhaphy?

Author Affiliations

Los Angeles, Calif

Arch Surg. 1995;130(4):448. doi:10.1001/archsurg.1995.01430040110026

We had the opportunity to read the article "Laparoscopic or Open Inguinal Herniorrhaphy? A Randomized Prospective Trial" by Payne and his colleagues1 in the September 1994 issue of the Archives. In their article, the authors indicated that in their control group (group 1) a tension-free technique similar to that described by Lichtenstein et al and Amid et al2 was used. The comparative study is flawed for several important reasons. First, the open tension-free procedure that was described by Payne during his talk at a hernia symposium in Indianapolis, Ind, in June 1993 was the original Lichtenstein procedure prior to its modifications many years ago. The modifications were based on our clinical observations and served to reduce the postoperative pain and recurrence rate. The changes, however, were not published until March 1993,2 7 months after Payne et al began their study. Therefore, the procedure used in the comparative

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