Inguinal hernia surgery in developing countries: should laparoscopic repairs be performed ?

Laparoscopy is a clear revolution in abdominal surgery and should be developed in dedicated experienced facilities in developing countries. However, compared to the Lichtenstein procedure, laparoscopic techniques of inguinal hernia repair have clear disadvantages, as the necessity of a general anaesthesia, of availability of CO2 and electricity, a higher cost and a risk of more life-threatening complications. The Lichtenstein technique is a much easier procedure can be easily performed under spinal or even local anaesthesia. The Lichtenstein technique should be considered as the standard of care of inguinal hernias not only in the developing countries, but in the whole world, as until now, no clear differences in term of recurrence and pain could be demonstrated between both techniques. The availability of a cheap mesh is still a challenge, and the use of mosquito nets should be further investigated.