Inguinal Hernia: Evidence on Open, Laparoscopic, and Robotic Surgical Approaches

Abstract

Introduction: Inguinal hernia corresponds to a bulge in the inguinal region caused by protrusion of the hernia sac. It is one of the most common surgical conditions worldwide and represents a challenge due to its high healthcare demand and functional impact. Nevertheless, questions persist regarding the efficacy, safety, and cost-effectiveness of the available surgical techniques. Methodology: A review of the available evidence was conducted using PubMed, Scopus, SciELO, and Web of Science (WoS), employing specific MeSH terms for inguinal hernia and robotic, laparoscopic, and open hernioplasty. Results: Since 2013, robotic surgery has increased in prevalence, emerging as the alternative associated with the shortest postoperative length of stay (−0.20 days) but also the highest cost. In contrast, the frequency of laparoscopic techniques has declined, as has that of open surgery. Opioid prescriptions were more intensive following laparoscopic and open procedures; however, updated educational interventions recommend the use of nonsteroidal anti-inflammatory drugs and acetaminophen. Among patients, laparoscopic surgery proved to be the most cost-effective alternative. Discussion: Our findings confirm that the open technique remains the most widely used approach, although its frequency has decreased. Laparoscopic and robotic approaches offer advantages in terms of conversion to open surgery, hospital stay, and functional recovery. Conclusion: Open and laparoscopic approaches have demonstrated safety and efficacy. Open surgery remains fully relevant, particularly in patients with complex comorbidities. Conversely, robotic surgery is emerging as a promising tool in complex or emergency settings.