This MRC funded study randomised 928 participants to receive either laparoscopic or open repair of groin hernia recruited by 27 consultant surgeons from 26 hospitals in the UK and Ireland. Self-completion postal questionnaires were used to assess general health status and clinical outcome annually to five years after surgery. Fewer respondents in the laparoscopic group reported groin pain at all time points; the difference between the groups lessened over time (5% at 24 months, 2% at 60 months) and reflected mild or very mild pain, rather than severe pain. The study concluded that laparoscopic repair reduces the risk of chronic pain and numbness. Using best estimate assumptions, the benefit that this represents in terms of quality of life tipped the balance in subsequent cost-effectiveness analyses, despite the extra costs due to a longer operation time.
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Grant AM, Scott NW, O'Dwyer P, MRC Laparoscopic Groin Hernia Trial Group. Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 2004;91(12):1570-1574.