We are pleased to respond to the points raised by Amid et al. First, our article clearly states that the repairs in our control group were performed in "a tension-free manner similar to that described by Lichtenstein et al and Amid et al."1 One of us (J.H.P.) recently visited the Lichtenstein Institute to observe their technique. No significant differences were noted. Second, while the truth of this statement is well recognized, the correspondents' 1993 article did not make reference to it. Third, as reported in our article,1 the average operating time (56 minutes) for the open repair group represents the time from skin incision to dressings as recorded by the circulating nurse. The other, longer times cited by the correspondents are from abstracts prepared early in the study. During the recent visit to the Lichtenstein Institute, operative times averaged 45 minutes per side. It is unlikely that our
Payne JH, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J. Laparoscopic or Open Inguinal Herniorrhaphy?-Reply. Arch Surg. 1995;130(4):448. doi:10.1001/archsurg.1995.01430040110027
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