Laparoscopic incisional hernia repair in an ambulatory surgery-extended recovery centre: a review of 259 consecutive cases
| Autor: | M. L. Ruíz-Juliá, A. Fernández-Zulueta, J. Marín-Morales, Francisco Javier Jiménez-Vega, S. Marrero-Cantera, B. M. Claro-Alves, José Manuel Lorente-Herce, P. A. Gallardo-García, R. De Quinta-Frutos |
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| Rok vydání: | 2013 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty Incisional hernia medicine.medical_treatment Surgicenters Perforation (oil well) medicine Humans Hernia Laparoscopy Herniorrhaphy Aged Aged 80 and over medicine.diagnostic_test business.industry General surgery Patient Selection Ambulatory Surgical Procedure Middle Aged medicine.disease Hernia Ventral Surgery Ambulatory Surgical Procedures Ambulatory Female business Abdominal surgery Recovery Room |
| Zdroj: | Hernia : the journal of hernias and abdominal wall surgery. 19(3) |
| ISSN: | 1248-9204 |
| Popis: | The high prevalence of incisional hernias and an average stay of 3–10 days for open procedures have made this pathology both a health problem and an economic issue. A protocol was developed for performing this procedure in an Ambulatory Surgery Center (ASC) with extended recovery. From January 2000 to December 2011, data about all laparoscopic incisional hernia repairs were gathered prospectively. The patients’ clinical features, hernia type, intraoperative and postoperative complications and reasons for hospital admission are studied. A total of 259 patients have been operated for incisional hernia (185) or recurrent hernioplasty (74) in our ASC. Laparoscopic repair was successful in 254 patients (98.07 %). Conversion to open surgery was necessary in five patients (1.93 %). A total of 50 patients (19.69 %) in whom surgery was completed laparoscopically were discharged the same day of surgery, 179 (70.47 %) at 24 h and 25 (9.84 %) required a stay of over 24 h. Postoperative pain was severe in 10 % of patients, moderate in 40 %, and mild in 50 %. Complications, mostly minor and self-limiting, were observed in 25 patients (9.84 %) during hospital stay. Five major complications that occured were: bile peritonitis, an acute peritonitis, due to an inadvertent intestinal perforation, and one intestinal obstruction by partial detachment of the mesh, an intra-abdominal hematoma and a colo-cutaneous fistula. There were no deaths in the series. The mean follow-up of patients was 29.35 months (range 12–129 months). The recurrence rate was 7.03 % (n = 18). Four trocar-site hernias were detected. It is essential to create a protocol with selection criteria that take into account the patient, his entourage, the anesthetic-surgical procedure, and a team dedicated to surgical laparoscopic surgery in an ASC with extended recovery to achieve good results in terms of morbidity and patient safety. |
| Databáze: | OpenAIRE |
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