Purpose: There is controversy regarding the adoption of laparoscopic inguinal hernia repair in the elderly population. The aim of this study was to determine whether there is a difference in 30-days postoperative outcome in this group of patients, when compared to open herniorrhaphy, using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methodology: Data was accessed from operative years 2015 to 2022. All patients aged 75 years and over undergoing elective inguinal hernia repair were retrieved from the database. SPSS software was used. Propensity scores were calculated and included in the multivariate analysis to adjust for selection biases. Results: The study population included 35’539 patients. A steady increase in the utilisation of laparoscopic approach was observed, from 23% in 2015, reaching 42% in 2022. The laparoscopic group had a longer mean operative time of 12 minutes (p<0.001), but a shorter hospital stays of 0.08 days (p<0.005). Overall, the proportion of people developing any serious postoperative complication was equivalent at 2.8% between two groups. In the laparoscopic group, there was a lower risk for superficial surgical site infection (SSI; p<0.05). However, there was a higher risk for urinary tract infection (P<0.005) and return to theatres (p<0.05). There were no statistically significant differences for organ space SSI, pneumonia, readmission and mortality.


 Conclusion: Laparoscopic inguinal hernia repair in the elderly population offers comparable outcomes to open approach, with shorter hospital stay and reduced risk of SSI, but increased chance of return to theatre.