Primarily because it has a lower recurrence rate, 20 minute operation, done
under local anesthesia with sedation instead of general anesthesia, almost
the same return to work, easier to find a surgeon competent to do it, less
expensive.

Basically, the advantages of open repair are greater than for laparoscopic
repair for a simple hernia when only one side is being done. The advantages
shift to laparoscopic when we're talking about bilateral repairs, or if it
is a recurrent hernia.

HMc

The pain for a bilateral open repair is substantial, return to normal
activities longer. The pain is less and return to normal activities shorter
for bilateral laparoscopic repair. This is because open bilateral will
require two 2-inch incisions through the abdominal wall (one for each side),
whereas in bilateral laparoscopic both sides are done through the same three
puncture wounds.

A unilateral laparsocopic repair is not unreasonable, but the pros are often
not worth the cons, as in my previous post. The amount of pain is likely to
be less, and return to work may be earlier with a unilateral laparoscopic
repair.

The risks of open vs laparoscopic are roughly equivalent, depending on your
state of health. General anesthesia is required for laparoscopic repair
(usually), and that in itself does indeed carry some risk to your life,
although not much in a normal healthy adult - in fact not much more (and
some would say less) risk than the intravenous conscious sedation used with
the local anesthesia for open repair.

An open unilateral hernia repair hurts a lot for about 2-3 days. Return to
normal activity is variable depending on pain tolerance and what "normal"
acitivities you're talking about. After a unilateral open repair, patients
can often return to their desk job in a week. If the job requires a lot of
standing or heavy lifting, it's more likely longer, maybe as long as 6
weeks. A bilateral open repair will hurt a lot for a week or maybe two - 4-6
weeks, maybe longer, before you'd want to return to alligator wrestling. A
bilateral laparsocopic repair hurts a little more than a unilateral repair,
usually return to work in a week or so, and 2-4 weeks before returning to
strenuous physcial activity.

THESE ESTIMATES ARE ONLY ESTIMATES and can vary widely depending on the
surgeon, the patient, the kind of work the patient does, his pain tolerance,
lack of complications (such as infection, hematoma or scrotal swelling), and
what constitutes "normal" activity.

HMc