2023, Volume 29, Issue 4
MINIMALLY INVASIVE VERSUS OPEN INGUINAL HERNIA REPAIR IN MILITARY PERSONNEL: A FOCUSED NARRATIVE REVIEW WITH IMPLICATIONS FOR AIRCREW
MICHAŁ JANIK1, PRZEMYSŁAW SROCZYŃSKI1, GRZEGORZ DOBKOWSKI1, KRZYSZTOF JĘDRAS1
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1Department of Surgery, Military Institute of Aviation Medicine
Autor korenspondencyjny: MICHAŁ JANIK; Department of Surgery, Military Institute of Aviation Medicine; email: mjanik@wiml.waw.pl
Streszczenie
Introduction: Inguinal hernia repair affects operational readiness, but direct evidence in military aircrew is sparse. We evaluated open and minimally invasive repair in military populations and interpreted the findings for aviation practice.
Methods: This focused narrative review used a reproducible PubMed search performed on 27 September 2026 for inguinal or groin hernia combined with military, armed-forces, aviation, or aircrew terms. International HerniaSurge guidelines were added for context. Direct military and aircrew evidence was prioritised and synthesised by publication era; no meta-analysis was attempted because designs, techniques, pathways, and outcomes were heterogeneous.
Results: Early comparative studies suggested less analgesic use and earlier occupational recovery after laparoscopic repair, although they predated contemporary perioperative pathways. Later military series supported the feasibility of both transabdominal preperitoneal and totally extraperitoneal repair. In 1,119 active-duty personnel, the approaches yielded similar Army Physical Fitness Test score changes, duty-restriction time, and time to first postoperative testing. Two uncontrolled aircrew reports described five aviators: one returned to full flight status four weeks after open anterior mesh repair, and four returned to cockpit duties 21 days after totally extraperitoneal repair.
Discussion: The evidence was observational and heterogeneous. Older studies predated contemporary perioperative pathways, and the two aircrew reports cannot define a preferred technique or a universal return-to-flight interval. Current guidelines support individualised selection according to patient and hernia characteristics, surgeon expertise, and resources.
Conclusions: Minimally invasive repair is a reasonable option for military personnel but is not uniformly superior to open repair. Decisions for aircrew should combine guideline-based hernia care with individualised aeromedical assessment.
Słowa kluczowe
Aviation Medicine, Herniorrhaphy, Laparoscopy, Return to Work, Physical Fitness, Chronic Pain