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Invited Commentary

George Fielding, MBBS
Arch Surg. 1995;130(6):577. doi:10.1001/archsurg.1995.01430060015002.
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As we move toward the end of the 20th century, the approach to many common surgical procedures is in a state of flux. With the introduction and rapid uptake of laparoscopic cholecystectomy around the world, there has been great enthusiasm toward extending these techniques into all aspects of general surgery. One of the first and obvious choices was inguinal hernia repair, which, apart from being a very common procedure, has a wide impact on the workforce. It was hoped that the laparoscopic approach would allow an early return to work, thereby saving the individual patient and the community large sums of money.

There has, however, been controversy, perhaps in hernia repair more so than in any other laparoscopic procedure. As Rutkow so elegantly describes in his article, the possible benefits of an early return to work with laparoscopic hernia surgery have been offset occasionally by very serious complications. The worst


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