Smaller Not Always Better: One case in which laparoscopic surgery is inferior to standard surgery - hernia repairs:

Overall, 87 of the 862 patients who had laparoscopic surgery needed a second repair of the same hernia within two years, compared to 41 of the 834 who got open incision repairs. That works out to 10.1 percent and 4.9 percent.

Twenty of the 78 surgeons doing laparoscopic surgery had done more than 250 such operations for groin hernias, also called inguinal hernias, and their recurrence rate was less than 5 percent, said Neumayer, a staff surgeon at the VA hospital and associate professor of surgery at the University of Utah.