Balancing recovery and costs in hernia repair: Laparoscopic vs. Open Surgery

Open vs. Laparoscopic Ventral Hernia Repair: Which is Best for Obese Patients?

Reese Marlowe in Health & Wellness November 2025 • 4 min read.

"A new study compares open and laparoscopic approaches for ventral hernia repair in obese patients, revealing key differences in recovery time and costs. Discover which method offers the best outcomes."

Obesity is a widespread health issue, and its association with ventral hernias is well-documented. Ventral hernias, which occur when tissue protrudes through an opening in the abdominal wall, are particularly common in individuals with a higher body mass index (BMI). As obesity rates continue to rise, understanding the best approaches for repairing these hernias becomes increasingly important.

Traditionally, ventral hernias have been repaired using open surgery, a method that involves making a larger incision to access and repair the hernia. However, with advancements in surgical techniques, laparoscopic surgery, a minimally invasive approach, has emerged as an alternative. Laparoscopic repair involves smaller incisions, the use of a camera to visualize the surgical area, and specialized instruments to perform the repair.

Recent studies suggest that laparoscopic ventral hernia repair (LVHR) may offer several advantages for obese patients compared to open repair. These potential benefits include shorter hospital stays, reduced postoperative pain, and quicker return to normal activities. However, LVHR can also be associated with higher costs due to the specialized equipment and techniques involved. This article will look at the facts to help you navigate this decision.

Laparoscopic vs. Open Repair: Weighing the Options for Obese Patients

Balancing recovery and costs in hernia repair: Laparoscopic vs. Open Surgery

A retrospective study published in Ars Medica Tomitana compared the outcomes of open and laparoscopic ventral hernia repair in obese patients. The researchers analyzed data from 100 obese patients (BMI > 30kg/m²) who underwent ventral hernia repair between 2014 and 2015. Eleven patients underwent laparoscopic repair, while 89 patients underwent open repair. The study compared several factors, including length of stay (LOS), hospitalization costs (HC), and operative time (OT).

The study revealed some key differences between the two approaches:

Length of Stay: Patients who underwent laparoscopic repair had a significantly shorter length of stay in the hospital (2.9 days) compared to those who underwent open repair (8.53 days).
Hospitalization Costs: Despite the shorter hospital stay, the hospitalization costs were higher for laparoscopic repair (5793.88 RON) compared to open repair (4634.94 RON). This is likely due to the cost of specialized equipment and materials used in laparoscopic surgery, such as composite meshes and endotackers.
Operative Time: The operative time was similar for both groups (approximately 119 minutes).
Wound Infections: Wound infections were only observed in the open repair group (7 patients). Seromas (fluid collection under the skin) occurred in both groups.

The study also noted that laparoscopic repair was performed only in elective surgery and for smaller hernias. Open repair was used for both elective and emergency cases, and for a wider range of hernia sizes. This suggests that patient selection plays a crucial role in determining the suitability of each approach.

Making the Right Choice for Your Hernia Repair

Deciding between open and laparoscopic ventral hernia repair requires careful consideration of individual factors. While laparoscopic repair offers the advantage of a shorter hospital stay, it may come with higher costs. Open repair, on the other hand, may be more suitable for larger or more complex hernias, but typically involves a longer recovery period. Discuss your options with your surgeon to determine the best approach for your specific situation and health needs. Ultimately, the goal is to achieve a successful hernia repair with minimal complications and a swift return to your normal life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What are the main differences between Open and Laparoscopic Ventral Hernia Repair for obese patients?

A recent study compared Open and Laparoscopic Ventral Hernia Repair methods for obese patients, highlighting key differences. Patients who underwent Laparoscopic Ventral Hernia Repair experienced a significantly shorter Length of Stay (LOS) in the hospital, averaging 2.9 days, compared to 8.53 days for Open repair. However, Hospitalization Costs (HC) were higher for Laparoscopic repair (5793.88 RON) than Open repair (4634.94 RON). Operative Time (OT) was similar for both methods. Wound infections were only observed in the Open repair group, while seromas occurred in both.

Why might Laparoscopic Ventral Hernia Repair be associated with higher costs despite a shorter hospital stay?

Laparoscopic Ventral Hernia Repair often involves higher costs due to the specialized equipment and techniques required. This includes the use of advanced tools, such as composite meshes and endotackers, and the expertise needed to perform minimally invasive surgery. While the shorter hospital stay can lead to some cost savings, the initial investment in specialized materials and technology can increase the overall cost compared to Open repair.

What factors should obese patients consider when deciding between Open and Laparoscopic Ventral Hernia Repair?

Obese patients should carefully consider several factors when choosing between Open and Laparoscopic Ventral Hernia Repair. Laparoscopic repair offers a shorter hospital stay, potentially leading to a quicker recovery. However, it may involve higher hospitalization costs. Open repair may be suitable for larger or more complex hernias and in emergency situations, but typically leads to a longer recovery period. The patient's overall health, the size and complexity of the hernia, and their individual preferences should all be discussed with the surgeon to determine the most suitable approach.

In what situations is Open Ventral Hernia Repair preferred over Laparoscopic Ventral Hernia Repair?

Open Ventral Hernia Repair is often preferred in several situations. It is frequently used for larger or more complex hernias that may be challenging to address laparoscopically. Also, Open repair can be performed in both elective and emergency cases, providing a versatile approach. Laparoscopic repair was only performed in elective surgery for smaller hernias. The surgeon's experience and the specific characteristics of the hernia play a critical role in determining the best surgical method.

How does the choice between Open and Laparoscopic Ventral Hernia Repair affect recovery and return to normal activities for obese patients?

The choice between Open and Laparoscopic Ventral Hernia Repair significantly impacts recovery and the return to normal activities for obese patients. Laparoscopic repair typically results in a shorter hospital stay and, potentially, less postoperative pain, facilitating a quicker return to daily routines. Open repair, while suitable for a wider range of hernia sizes and complexities, often involves a longer recovery period due to the larger incision. The goal of either method is to achieve a successful hernia repair with minimal complications, allowing patients to return to their normal lives as quickly as possible. The study shows that patients who underwent Laparoscopic repair had a much shorter stay in the hospital.