Surgeons 'will ignore hernia ruling'

A keyhole hernia operation costs almost double open surgery

Plans to reduce the number of keyhole groin hernia operations will lead to more patient pain, say surgeons.

And they say they will ignore guidance by an advisory committee to switch to open surgery for 90% of all operations.

Roger Motson, President of the Association of Endoscopic Surgeons of Great Britain and Ireland, said many surgeons considered the open surgery "barbaric" since they had developed new techniques.

He said he would be advising members to ignore new guidelines by the National Institute of Clinical Excellence (NICE) for hernias of the groin.

Insufficient Evidence

NICE chief executive Andrew Dillon said they were issuing the guidance for groin hernias because they had "insufficient evidence" to recommend these operations.

"There is insufficient evidence to give a general recommendation in favour of key-hole surgery for inguinal (groin) hernia at the present time."

But he said that keyhole surgery should still be considered for recurring hernias and for those patients with hernias on both sides.

It feels more barbaric to go back to the old way

Mr Roger Motson

NICE said open surgery costs the NHS £412 an operation compared to £747 for a keyhole surgery.

Mr Motson said keyhole surgery is less painful for patients than open surgery, but he blamed an increase in cost for what he called the "perverse" decision by NICE.

Costs higher

He said that the costs of keyhole surgery could be higher if disposable equipment is used, but said that the use of reusable equipment brings the costs down.

And he said NICE had failed to take into account that patients having keyhole surgery recovered quicker.

Hernia factfile

About 105,000 people develop hernias each year

98 out of 100 groin hernia sufferers are male

As many as 3 out of ten people with one groin hernia go on to develop one on the other side

"We are disappointed for the patients. Most people would say this is going backwards to something that is more painful. It feels barbaric to go back to the old way."

Mr Motson said an unpublished study of patients at the Royal Surrey County Hospital, Guildford, who had experienced both sorts of operation, showed that nine out of ten preferred the keyhole surgery.

He said keyhole surgery has been shown to be clinically effective with clear benefits for patients; that it causes less pain; less risk of infection and that those having this type of operation could be back at work much quicker than those having an open operation.