Sixteen patients were included. Direct in-hospital costs were higher for unilateral EH. Direct out-of hospital costs were lower after EH in some studies. Indirect costs were lower for EH. Total costs were higher for EH in three studies and lower in one study. With EH, QoL was better, pain was less, operating time was longer and time return to work and other activities was shorter. tension-free meshplasty and herniorrhaphy are safe, simple andapplicable even in elderly patients after adequate preoperative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.