Evidence map›Paper›PMID 42257724›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2026

Environmental footprint of open versus laparoscopic inguinal hernia repair.

Agathe Herdwig, Paul Boulard, Charlotte Martin, Sam Hemati, Charlotte Maulat, Marion Castel-Molières, Fabrice Muscari

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Agathe HerdwigDigestive Surgery and Liver Transplantation Department, Toulouse University Hospital Center, 1 avenue Jean Poulhès, Toulouse, 31059, France.
Paul BoulardDigestive Surgery and Liver Transplantation Department, Toulouse University Hospital Center, 1 avenue Jean Poulhès, Toulouse, 31059, France.ORCID http://orcid.org/0009-0002-3638-8310
Charlotte MartinAnesthesiology Department, Toulouse University Hospital Center, Toulouse, France.
Sam HematiDigestive Surgery and Liver Transplantation Department, Toulouse University Hospital Center, 1 avenue Jean Poulhès, Toulouse, 31059, France.
Charlotte MaulatDigestive Surgery and Liver Transplantation Department, Toulouse University Hospital Center, 1 avenue Jean Poulhès, Toulouse, 31059, France.
Marion Castel-MolièresPharmacy Department, Toulouse University Hospital Center, Toulouse, France.
Fabrice MuscariDigestive Surgery and Liver Transplantation Department, Toulouse University Hospital Center, 1 avenue Jean Poulhès, Toulouse, 31059, France. muscari.f@chu-toulouse.fr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare the environmental impact of ambulatory inguinal hernia repair performed using open surgery versus laparoscopy through a life cycle assessment (LCA).

methodsA descriptive, prospective, non-interventional study was conducted at Toulouse University Hospital between October 2024 and February 2025. Intraoperative consumption of materials, energy, and medical devices was prospectively recorded in real time. Environmental impacts were quantified using a comprehensive LCA covering the full life cycle of all products used. The two surgical approaches were compared across 16 environmental impact categories of which the 8 most contributive were analyzed in detail.

resultsLaparoscopic repair was associated with a 1.44-fold higher environmental impact than open surgery, with an overall score of 4.67 x 10⁻³ versus 3.23 x 10⁻³, respectively. This difference corresponded to an additional 15.5 kg CO₂-equivalent emissions per procedure. Single-use non-woven materials and cotton-based products were the main contributors, whereas operating room energy consumption and sterilization of reusable devices contributed minimally.

conclusionIn ambulatory inguinal hernia repair, the choice of surgical approach has a substantial influence on environmental impact, underscoring the importance of integrating environmental considerations into operative decision-making.

Indexed as

Ambulatory Surgical ProceduresEnvironmentHernia, InguinalHerniorrhaphyLaparoscopyHumansProspective StudiesEnvironmental impactHernia repairLaparoscopic surgeryLife cycle assessmentOpen surgery

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.